Clinical experience of the use of vitamin D in the complex treatment of vulvar lichen sclerosus
Year: 2026
Type: article
Study design: Clinical Trial
Abstract: Background. Given the frequent relapses of vulvar lichen sclerosus (VLS) and widespread resistance to treatment, the search for new pathogenetically grounded therapeutic options aimed at improving disease course and reducing the frequency of exacerbations is an urgent task of modern clinical medicine.Objective of the study: to evaluate the clinical efficacy of cholecalciferol as a systemic adjuvant immunomodulatory agent in addition to standard therapy with topical corticosteroids in patients with VLS and laboratory-confirmed vitamin D deficiency.Materials and methods. This prospective study included 100 women aged 18 to 70 years with a verified diagnosis of VLS and serum 25-hydroxyvitamin D levels below 30 ng/mL. The control group (n = 50) received standard monotherapy with topical corticosteroids clobetasol propionate 0.05%. The intervention group (n = 50) additionally received oral cholecalciferol at a dose of 10,000 IU/day for 12 weeks, followed by a maintenance dose of 4,000 IU/day. The follow-up period lasted 12 months, during which symptom severity was assessed using a visual analogue scale, and objective tissue changes were recorded.Results. The combined approach demonstrated a statistically significant advantage. Already after four weeks, a markedly faster reduction in visual analogue scale symptom scores was observed in the intervention group. Complete clinical remission was achieved in 42% of patients in the intervention group compared with 18% in the control group. After one year of follow-up, the relapse rate was 12% in the intervention cohort versus 38% in the control group. Objective examination confirmed significantly more active restoration of the elasticity of affected tissues, rapid epithelialization of existing microfissures, and sustained regression of hyperkeratosis under conditions of achieving target vitamin D concentrations.Conclusions. Normalization of nutritional status significantly slows the pathological progression of dermal sclerosis and effectively enhances the action of topical corticosteroids. Long-term cholecalciferol administration creates a favorable immunological milieu, which substantially reduces the overall relapse rate and promotes regeneration of squamous epithelium. Screening for vitamin D deficiency and its subsequent correction should be integrated into the management strategy for patients with VLS.
Source: Reproductive Endocrinology
Language: English
Topic: Genital Health and Disease
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223566876