Photodynamic therapy of vulvar intraepithelial neoplasia using methyl aminolevulinate

摘要

Vulvar intraepithelial neoplasia is a pre-cancerous lesion that defines the grade of dysplasia of the vulvar squamous epithelium. According to the classification of the International Society for the Study of Vulva Diseases (ISSVD) 2004, the lesions may be low grade (VIN1) or high grade (VIN2 and VIN3) (1).Currently, there is little consensus regarding the optimal treatment method. Instead of vulvectomy, the tendency is to use more conservative forms of treatment such as laser ablation or local excision. Laser ablation is one of the most generally indicated methods, especially in young women with multicentric disease, in view of its good cosmetic and functional results. Various topical medical treatments including imiquimod, 5FU, dinitrochlorobenzene, bleomycin or interferon-oc have also been tried, but they are sometimes very painful and have only limited success (2). No therapy is entirely satisfactory in all cases and the treatment chosen depends on the patient's age and the site and extent of the lesions, together with the biopsy results.