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Research Letter
May 6, 2020

Association of Topical Corticosteroids With Reduced Vulvar Squamous Cell Carcinoma Recurrence in Patients With Vulvar Lichen Sclerosus

Author Affiliations
  • 1St Vincent’s Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
  • 2Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  • 3Royal North Shore Hospital, Sydney, New South Wales, Australia
  • 4New South Wales Health Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia
  • 5Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
JAMA Dermatol. Published online May 6, 2020. doi:10.1001/jamadermatol.2020.1074

Vulvar lichen sclerosus (vLS), if untreated, results in a 5% to 7% increased lifetime incidence of vulvar squamous cell carcinoma (vSCC) and differentiated vulvar intraepithelial neoplasia (dVIN).1,2 This incidence rate can be reduced by suppressive topical corticosteroid treatment3; however, whether topical corticosteroid therapy can also reduce the rate of vSCC recurrence remains unknown. Current data report a 5-year rate of recurrence of 44% to 47% after surgical treatment.4,5 Furthermore, if a patient had 1 recurrence, their chance of another recurrence within 5 years rises to 80%.5 Determining whether topical corticosteroid treatment after surgery can reduce the risk of recurrence is important because up to 25% of women with vLS report not being treated with topical corticosteroid after vSCC excision.6 If shown to have an association with preventing cancer recurrence, topical corticosteroid therapy could be readily implemented.

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