Photodynamic Therapy Combined with Acitretin for Genital Lichen Sclerosus

Genital lichen sclerosus (GLS) treatment remains challenging. Both photodynamic therapy (PDT) and retinoids exhibit efficacy, and dermoscopy shows promise for evaluating responses. This study aims to investigate the efficacy and safety of PDT combined with acitretin in GLS. Patients were divided into PDT monotherapy (n=10) and combination groups (n=10). Symptoms, lesion characteristics, and dermoscopic features were scored at baseline, week 6, and week 12. By week 12, 40% of patients in the monotherapy group and 60% in the combination group achieved an Investigator's Global Assessment (IGA) score of ≤1. Combination therapy showed earlier IGA reduction at week 6, with decreased dermoscopic white structureless areas and white shiny streaks. Both groups demonstrated significant symptom and lesion improvement by week 12. Combining PDT with acitretin shows enhanced efficacy in GLS treatment, and dermoscopy is a valuable tool for assessing therapeutic response. Further large-scale trials are warranted.