Treatments
The first line treatment was ultra-potent topical corticosteroid (CP) in 91.8% (n=112). In 32 cases (25.2%), a second line treatment was necessary to control symptoms and in 8 cases (6.3%) more than one change of treatment was needed. As options, we used more often an alternative topical corticosteroid (hydrocortisone, betamethasone and triamcinolone), followed by calcineurin inhibitors in 10 cases (8.2%), methotrexate in 4 cases (3.3%), retinoids in 2 cases (1.6%) and systemic steroids in one case (0.8%). In one case, a fourchette plasty was performed to treat dyspareunia associated with synechia.
Regarding adverse effects and complications of the treatments used, 18.8% (n=21) developed a vulvovaginal yeast infection (all associated with ultrapotent topical corticosteroids use) and, in one woman, retinoids had to be stopped due to suicidal ideation.