Materials and Methods
A retrospective cohort study including all the women followed in the Lower Genital Tract Disease Unit of Centro Hospitalar Universitário São João during a period of eleven years (January 2008-December 2018), with the diagnosis of vulvar LP was performed. Patients were referred by the primary care providers, emergency room or from other consultations. The diagnosis of LP was made based on clinical features and/or on histology, according to the ISSVD recommendations.9–12
Data were collected through consultation of the electronic files of each patient, where all the information is recorded. We retrieved information on the age at diagnosis, smoking habits, menopause status and the use of menopause hormone therapy. Presenting symptoms and anatomical changes observed in physical examination that contributed to the diagnosis of LP were also evaluated. Follow-up was made, at least, annually. Shorter interval visits were performed whenever deemed necessary: either due to poor control of symptoms or presence of suspicious lesions. Data on the treatments performed, both topical and systemic and the need to escalate therapy for uncontrolled disease were also evaluated. We usually advocate a scheme of application of clobetasol propionate (CP) once a day for 4 weeks, followed by once every other day for another 4 weeks, and finally twice a week for another 4 weeks, completing 3 months of initial treatment. Manutention therapy is usually recommended; patients are advised to use up to 60 g of CP/year.
Whenever a suspicious lesion was found during follow-up or when first line treatments were not effective in controlling the disease, vulvar biopsies were performed. The results of all biopsies performed were retrieved and analyzed.
Descriptive and inferential analysis were performed using IBM SPSS Statistics Version 21. We performed a descriptive analysis, with continuous variables summarized as means with standard deviations and categorical variables as percentages of patients in each category.
The study was approved by the ethics committee of the institution (nº182/19).