{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:57:05Z","timestamp":1760403425950,"version":"build-2065373602"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Vulvar Lichen Sclerosus (VLS) is a chronic relapsing inflammatory disease involving the anogenital region, resulting in vulvar atrophy and distressing symptoms. A preliminary prospective observational study was conducted to investigate the efficacy of hybrid cooperative complexes (HCC) of low- and high-molecular weight hyaluronic acid (HA) for the treatment of female patients with vulvar atrophy and lichen sclerosus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Female patients with coexisting vulvar atrophy and lichen sclerosus (<jats:italic>N<\/jats:italic>=15) received two HCC injections at 32 mg\/ml (one month apart). At baseline, 1-month, 3-months, and 6-months post-treatment, patients were assessed for reference dermatoscopic parameters using videodermatoscopy, symptoms, quality of life (Dermatology Life Quality Index [DLQI]) and sexual function (Female Sexual Function Index [FSFI]). The hypoechoic band was evaluated using ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both DLQI and FSFI scores improved with HCC treatment, with significant improvements at 1-month, 3-months and 6-months post-treatment vs baseline (<jats:italic>p<\/jats:italic>&amp;lt;0.05 for all). The thickness, homogeneity and smoothness of the hypoechoic band increased post-treatment. No side effects or complications were reported. The reference dermatoscopic features of vascularisation, blue grey dots, purpuric lesions, horny pearls, scales, ice silvers structures or whitish background were reduced at 6-months post-treatment vs baseline; significant reductions were observed for scales (baseline vs 1-month and 6-months post-treatment; <jats:italic>p<\/jats:italic>&amp;lt;0.05 for both). Scores for pain, itching, and burning were reduced at 1-month, 3-months and 6-months post-treatment vs baseline (<jats:italic>p<\/jats:italic>&amp;lt;0.05 for all).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>These preliminary results add to the growing body of evidence highlighting the promising efficacy of HCC of HA for the treatment of VLS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1540428","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T16:25:53Z","timestamp":1760372753000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dermoscopy for monitoring therapeutic response to hybrid cooperative complexes of hyaluronic acid in women with vulvar lichen sclerosus and atrophy"],"prefix":"10.3389","volume":"12","author":[{"given":"Giulio","family":"Rizzetto","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"De 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