Comparison of the Efficacy of Photodynamic Therapy and Focused Ultrasound in the Treatment of Vulvar Lichen Sclerosus

This study aimed to analyze the efficacy and safety of photodynamic therapy based on 5-aminolevulinic acid (ALA-PDT) and high-intensity focused ultrasound (HIFU) in the treatment of vulvar lichen sclerosus (VLS). A retrospective analysis was conducted on 160 patients with VLS. Among them, 85 patients were treated with ALA-PDT (3 times, with an interval of 14 days), and 75 patients were treated with a single session of HIFU. Clinical symptoms, objective signs, Dermatology Life Quality Index (DLQI) scores, adverse reactions, and recurrence rates were evaluated. At 3 months, the ALA - PDT group had significantly better relief of vulvar pruritus and lesion area reduction than HIFU (P < 0.05). At 6 months, it maintained superiority, with a lower recurrence rate (7.06% vs. 18.67%, P = 0.027) and better DLQI improvement (P < 0.05). ALA-PDT is a safe and effective treatment method.