Imiquimod cream and CO2 laser vaporization in vulvar intraepithelial neoplasia (VIN) 2/3 treatment

Objectives: To compare the use of topical 5% imiquimod (IMQ) cream or CO2 laser vaporization as the treatment of vulvar intraepithelial lesions (VIN) 2/3 and to evaluate the degrees of residual or recurrent lesions. Materials and Methods: Twenty-nine women with VIN 2/3 were separated into two groups, according to the proposed treatments. All were submitted to collection of vulvar swabs for DNA genotyping of human papillomavirus (HPV), vulvoscopy, and biopsy of the found lesions. After treatment they were followed up in quarterly consultations to (until) possible appearance of new lesions or along one year. Results: The findings were similar in effectiveness and presence of residual or recurrent lesions on the performed treatments. However, patients treated with topical 5% IMQ cream had less severe lesions in histological recurrence when compared to those submitted to the CO2 laser vaporization. Conclusions: The effectiveness of topical 5% IMQ cream was similar to that of CO2 laser vaporization. There was no difference between the treatments for the presence of residual or recurrent lesions. However, patients who received IMQ had less aggressive lesions than those submitted to the treatment with CO2 laser vaporization.

Vulvar intraepithelial neoplasia; CO2 vaporization; Imiquimod cream.

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