An exploratory, prospective cohort study of non-invasive dynamic quadripolar radiofrequency energy in vulvar lichen management. The new-generation DQRF™ option

Abstract

Introduction: The main vulvar lichen treatment goal is itch reduction; improving and preserving the skin integrity and texture, healing the fissures and erosions, and preventing the later disfiguring fibrosis are the other crucial treatment goals. The side effect burden of high-potency topical corticosteroids, the current gold standard, can be heavy and alternative options are welcome. The paper illustrates the first exploratory outcomes in vulvar lichen planus and lichen sclerosus by the latest low- energy technological evolution of radiofrequency treatments, Dynamic Quadripolar RadioFrequency™, in synergistic combination with in-depth penetration of active principles via Ultra-Pulsed Radioporation™. Methods: Explorative cohort study in 58 ambulatory women 27 to 80 years old, eighteen nulliparous and 26 uniparous, 53.4% in the postmenopausal period. The DQRF™ treatment program mainly aimed at symptom control, with four weekly sessions - 10 minutes over the lichenified vulvar areas and 10 minutes of vaginal rejuvenation even without evidence of lichen vaginal extension. Assessments (baseline and at the end of the treatment cycle): pain and dyspareunia (10-cm impromptu Visual Analogue Scales), vulvar burning (4-score Likert-like impromptu scale), vulvar lesions (binary evaluation - Yes / No). Results: After a month, vulvar lichen inflammation appeared cooled down, and all cohort women reported dramatic improvements in daily and sexual symptoms - variable between -81.2% and -92% for pain, burning and itching, and -83% for dyspareunia. Conclusions: Control of lichen inflammation, as documented by sequential photographs, is likely the rationale behind the very favourable outcomes after DQRF™ + UPR™ treatment. Well-designed comparative studies are critical to defining the role of the novel radiofrequency technology in vulvar lichen management.