Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report

Turner syndrome (TS) is a rare clinical condition associated with a completely or partially absence, or structural abnormality of an X chromosome, mainly representing as short stature and skeletal anomalies, female hypergonadotropic hypogonadism and infertility. Skin is frequently involved in TS, es...

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Main Authors: Yukun Wang, Jie Liu
Format: Article
Language:English
Published: Elsevier 2024-02-01
Series:Photodiagnosis and Photodynamic Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S1572100023006610
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author Yukun Wang
Jie Liu
author_facet Yukun Wang
Jie Liu
author_sort Yukun Wang
collection DOAJ
description Turner syndrome (TS) is a rare clinical condition associated with a completely or partially absence, or structural abnormality of an X chromosome, mainly representing as short stature and skeletal anomalies, female hypergonadotropic hypogonadism and infertility. Skin is frequently involved in TS, especially autoimmune diseases like vitiligo and lichen sclerosus (LS).Here, we present a 10-year-old Chinese girl with TS combined with both vulvar LS (VLS) and extragenital LS, who had been misdiagnosed as eczema and vitiligo for years. In order to control LS sufficiently and allay the parents’ concerns of potential side effects of topical corticosteroids, she was prescribed with tacrolimus ointment on the extragenital lesions, and photodynamic therapy (PDT) for vulvar lesions. For PDT regimen, we used 5-aminolevulinic acid (ALA) as photosensitizer and 633 nm red light to irradiate the lesion area at 60 mW / cm2 for 30 min each time. After 6 times of treatment at 2-week intervals, a satisfactory remission of both pruritus and lesion severity was achieved.So far, the guideline on TS did not include LS as a common comorbidity to raise attention. However, accurate diagnosis and effective treatment are essential for LS to avoid the possibilities of developing labial atrophy, adhesion, or even vulvar cancer. Based on our research, PDT can significantly relieve subjective symptoms, objective lesion severity and histopathological changes of VLS with good tolerance, and therefore can also be a safe and effective therapeutic alternative in such comorbidity in TS patients.
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spelling doaj-art-72c255beeadf49f1a5a6d3ab87b70fa22025-08-20T01:54:51ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002024-02-014510393210.1016/j.pdpdt.2023.103932Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case reportYukun Wang0Jie Liu1Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Center for Translational Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, ChinaCorresponding author.; Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Center for Translational Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, ChinaTurner syndrome (TS) is a rare clinical condition associated with a completely or partially absence, or structural abnormality of an X chromosome, mainly representing as short stature and skeletal anomalies, female hypergonadotropic hypogonadism and infertility. Skin is frequently involved in TS, especially autoimmune diseases like vitiligo and lichen sclerosus (LS).Here, we present a 10-year-old Chinese girl with TS combined with both vulvar LS (VLS) and extragenital LS, who had been misdiagnosed as eczema and vitiligo for years. In order to control LS sufficiently and allay the parents’ concerns of potential side effects of topical corticosteroids, she was prescribed with tacrolimus ointment on the extragenital lesions, and photodynamic therapy (PDT) for vulvar lesions. For PDT regimen, we used 5-aminolevulinic acid (ALA) as photosensitizer and 633 nm red light to irradiate the lesion area at 60 mW / cm2 for 30 min each time. After 6 times of treatment at 2-week intervals, a satisfactory remission of both pruritus and lesion severity was achieved.So far, the guideline on TS did not include LS as a common comorbidity to raise attention. However, accurate diagnosis and effective treatment are essential for LS to avoid the possibilities of developing labial atrophy, adhesion, or even vulvar cancer. Based on our research, PDT can significantly relieve subjective symptoms, objective lesion severity and histopathological changes of VLS with good tolerance, and therefore can also be a safe and effective therapeutic alternative in such comorbidity in TS patients.http://www.sciencedirect.com/science/article/pii/S1572100023006610Lichen sclerosusTurner syndromePhotodynamic therapy5-aminolevulinic acid
spellingShingle Yukun Wang
Jie Liu
Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report
Photodiagnosis and Photodynamic Therapy
Lichen sclerosus
Turner syndrome
Photodynamic therapy
5-aminolevulinic acid
title Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report
title_full Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report
title_fullStr Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report
title_full_unstemmed Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report
title_short Lichen sclerosus associated with Turner syndrome treated with photodynamic therapy: A case report
title_sort lichen sclerosus associated with turner syndrome treated with photodynamic therapy a case report
topic Lichen sclerosus
Turner syndrome
Photodynamic therapy
5-aminolevulinic acid
url http://www.sciencedirect.com/science/article/pii/S1572100023006610
work_keys_str_mv AT yukunwang lichensclerosusassociatedwithturnersyndrometreatedwithphotodynamictherapyacasereport
AT jieliu lichensclerosusassociatedwithturnersyndrometreatedwithphotodynamictherapyacasereport