Evaluation of white lesions of vulva treated with focused ultrasound

OBJECTIVE: To explore the feasibility and efficacy of focused ultrasound for the treatment of vulvar dystrophy, including squamous hyperplasia (SH) and lichen sclerosus (LS). METHODS: A total of 76 eligible patients with vulvar dystrophy (45 SH and 31 LS) were treated with focused ultrasound between 1999 and 2002. Before and after ultrasound therapy, both ultrasonography and biopsies of the lesions were performed to monitor and evaluate the changes of the lesion being treated. The positive expressions of CD34 (cluster of differentiation of endothelial cells), a marker of the epithelial cells of blood vessels and myelin basic protein (MBP), a marker of the oligodendrocytes and Schwann cells were tested using the streptavidin-peroxidase (SP) immunohistochemistry method before and after the ultrasound procedure to evaluate the effects of ultrasound treatment. RESULTS: In two years, follow-up, 49 of 76 cases (32 SH and 17 LS) were cured, 23 (11 SH and 12 LS) improved, and 4 (2 SH and 2 LS) persisted. The response rate was 94.7% (72/76). The positive expression of CD34 and MBP significantly increased at the treated region (P < 0.05). Grey-scale ultrasound imaging showed a localized hypoechoic region after the treatment, which recovered to normal appearance within 7 - 10 days. CONCLUSION: Vulvar dystrophy can be treated with focused ultrasound effectively and safely. This approach appears to be a new promising treatment method, although further studies are still needed.