Liquen escleroso vulvar posterior al fenómeno de Koebner, una serie de casos

The Koebner phenomenon has been described as a triggering factor in some dermatological pathologies (psoriasis, vitiligo, and lichen planus). It has a multifactorial origin that includes genetic, immunologic, hormonal, infectious, idiopathic and traumatic aspects; in the latter, vulvar lichen sclerosus (VLS) is targeted, given the symptomatology and clinical findings. From this point of view, a descriptive study of a series of five histologically confirmed cases of VLS consequent various traumas was performed, where the effectiveness of platelet growth factors in the treatment of VLE following Koebner phenomenon was evaluated. The age range fluctuated from 26 to 62 years. In each case, the antecedent of Koebner phenomenon was: cases 1 and 5 previous intervention (labiaplasty); cases 2 vulvar cancer (received chemotherapy and radiotherapy); case 3 treatment with trichloroacetic acid and steroids; case 4 cervical cancer (received chemotherapy and radiotherapy and cesium implants). The predominant symptom was vaginal dryness in a 4:5 ratio; the clinical findings, adhesions of the labia minora and majora 3:5; besides vulvar fissure and clitoral phimosis 2:5. Of the total number of cases, four of them received platelet-rich plasma (PRP) and simultaneously two Choukroun membranes, in addition to CO2 laser. Clinical evolution was favorable after each session in most of the treated patients, with a 4:5 ratio. It was concluded that the combined therapy with platelet growth factors and CO2 laser was effective in treating VLS after Koebner's phenomenon, the majority of cases have shown a satisfactory evolution.