{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:08:37Z","timestamp":1791922117201,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T00:00:00Z","timestamp":1703635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy and safety of a novel non\u2010ablative Nd:YAG\/Er:YAG dual laser treatment for vulvar lichen sclerosus (LS) in comparison with the recommended first\u2010line therapy with topical steroid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A randomised investigator\u2010initiated active\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Single tertiary referral centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women with vulvar LS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomisation (2:1) to Nd:YAG\/Er:YAG laser therapy or topical clobetasol proprionate therapy. Four laser treatments at 0, 1, 2 and 4\u2009months or decreasing doses of steroid for 6\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The primary outcome was the change in objective validated clinical LS score in the laser arm between baseline and 6\u2009months. Secondary outcomes were laser tolerability\/safety, symptom scores and patient satisfaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010six women were included, 44 in the laser group and 22 in the steroid group. The total LS score decreased by \u22122.34\u2009\u00b1\u20091.20 (95% CI \u22122.71 to \u22121.98) in women treated with laser compared with a decrease of \u22120.95\u2009\u00b1\u20090.90 (95% CI \u22121.35 to \u22120.56) in those receiving steroid applications (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Laser treatment was safe and well tolerated. Subjective severity scores (on visual analogue scale) and vulvovaginal symptoms questionnaire scores improved similarly for the laser and steroid arms without significant differences between the two treatments. Patient satisfaction was higher in the laser arm than in the steroid arm (<jats:italic>p<\/jats:italic>\u2009=\u20090.035).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010ablative dual Nd:YAG\/Er:YAG laser therapy was safe and significantly improved clinical outcome and subjective symptoms at the 6\u2010month follow up. This suggests that laser may be a promising alternative to corticosteroid therapy. However, the authors caution regular follow ups because of the premalignant nature of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17737","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T10:46:26Z","timestamp":1703673986000},"page":"740-749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Nd:<scp>YAG<\/scp>\/Er:<scp>YAG<\/scp> dual laser compared with topical steroid to treat vulvar lichen sclerosus: A randomised controlled trial"],"prefix":"10.1111","volume":"131","author":[{"given":"Irena","family":"Zivanovic","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics Cantonal Hospital Frauenfeld  Frauenfeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8235-1239","authenticated-orcid":false,"given":"Marianne","family":"Gamper","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Cantonal Hospital Frauenfeld  Frauenfeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Fesslmeier","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Cantonal Hospital Frauenfeld  Frauenfeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Walser","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Cantonal Hospital Frauenfeld  Frauenfeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-578X","authenticated-orcid":false,"given":"Sigrid","family":"Regauer","sequence":"additional","affiliation":[{"name":"Diagnostic and Research Institute of Pathology Medical University Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1116-8912","authenticated-orcid":false,"given":"Volker","family":"Viereck","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Cantonal Hospital Frauenfeld  Frauenfeld Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16241"},{"key":"e_1_2_12_3_1","first-page":"1","volume-title":"EuroGuiDerm guideline lichen sclerosus version 1. European Centre for Guidelines Development","author":"Kirtschig G","year":"2023"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2015.0643"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1106318"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2019.01.023"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001482"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000512"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14353"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004332"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004409"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.919135"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-023-06300-7"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2023.06.003"},{"key":"e_1_2_12_15_1","first-page":"22","article-title":"New skin treatment possibilities with PIANO mode on an Nd:YAG laser","volume":"1","author":"Lukac M","year":"2011","journal-title":"J Laser Health Acad"},{"key":"e_1_2_12_16_1","first-page":"1","volume-title":"The laser essentials \u2013 the cookbook for functional gynecology and aesthetics","author":"Vizintin Z","year":"2022"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-023-07055-z"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404\u2010023\u201007162\u2010x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-18"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2012.02814.x"},{"key":"e_1_2_12_21_1","first-page":"1825","article-title":"Clinical scoring system for vulvar lichen sclerosus. Erratum","volume":"17","author":"G\u00fcnthert AR","year":"2020","journal-title":"J Sex Med"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.23311"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7184.167169"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/life13112146"},{"key":"e_1_2_12_25_1","first-page":"11","article-title":"Lichenoide vulvaerkrankungen. Lichen sclerosus und lichen planus: differenzialdiagnostik und behandlung","volume":"1","author":"Dedes I","year":"2019","journal-title":"Gyn\u00e4kologie"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0b013e318282600b"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000000549"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-009-1069-5"},{"key":"e_1_2_12_29_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.14892"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-019-04148-9"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001727"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijwd.2019.05.007"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.17737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T01:56:52Z","timestamp":1712023012000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.17737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,27]]},"references-count":32,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/1471-0528.17737"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.17737","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,27]]},"assertion":[{"value":"2023-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}