Physical therapy in the treatment of planus liquen sequelae with photobiomodulation. Innovation and a unique case report in the world.

Josefa Ugalde, Daine Paza, Aline Ronis, Esteban Fortuny, Maria Elena Silva, Karin Fernandez Iturra, Marcus vinicius De Mello Pinto
Purpose:

The main objective of the project was to develop a treatment to accelerate the healing process of the lesions that had led to the patient's critical condition, caused by the advanced stage of vulvar lichen planus, through the application of the Scar Acceleration Method (MAC®) with low-intensity laser therapy and photopharmaceuticals.

Methods:

The treatment lasted five months and involved the use of MAC®, which combines low-intensity laser therapy and the application of a photoactive agent (1% methylene blue + 0.1% estriol in topical cream). Phototherapy with LEDs (red, blue, and amber) was also used, adjusting emission times between 150 and 600 seconds. The study followed a case report design, and an adapted severity scale was applied to measure the patient's progress

Results:
  • Second session: Improvement in the patient’s urination.
  • Third month: Reappearance of the labia majora, labia minora, and clitoral hood.
  • Fourth month: Small opening of the vaginal introitus, and the patient could urinate normally.
  • Fifth month: Complete regeneration of the vulvovaginal tissue, restoring normal anatomy and functionality, including the ability to urinate without difficulty.
Conclusion(s):

The treatment using the Scar Acceleration Method achieved complete regeneration of the patient's vulvovaginal tissue, allowing for full restoration of anatomy and functionality. Low-intensity laser therapy has proven to be an effective option for managing advanced cases of vulvar lichen planus. This case highlights new methodologies to address common problems in the population, with a positive impact on the patients' quality of life. Despite the complexity of treating vulvar lichen planus, this technique presents itself as a safe, painless, and fast-acting option.

Implications:

This project has important implications for clinical practice in physiotherapy and gynecology, as it offers an effective non-surgical approach for treating severe cases of vulvar lichen planus. The results suggest that this type of treatment could be integrated into the management of patients with similar conditions, improving their quality of life and avoiding more invasive interventions.

Funding acknowledgements:
We would like to thank Dr. Marcus Vinicius and Dr. Aline Ronis, creators of the MAC methodology for photobiomodulation.
Keywords:
Liquen Vulvar Plano
Methodology MAC
photobiomodulation
Primary topic:
Pelvic, sexual and reproductive health
Second topic:
Women's health
Third topic:
Basic science including molecular and cellular health
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Instituto Celulare
Provide the ethics approval number:
CEP 00242
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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