Multicenter within-patient observational study reveals extended recurrence-free intervals in refractory lichen sclerosus, indicating methotrexate provides a non-surgical option.
Low-dose methotrexate (MTX) has been used for corticosteroid-refractory lichen sclerosus, but its effect on differentiated vulvar intraepithelial neoplasia (dVIN) recurrence has never been reported. In this first multicenter within-patient observational study, all six continuing patients exceeded their shortest pre-MTX recurrence-free interval, and three achieved sustained reduction in topical corticosteroid use. These findings support prospective evaluation in the MERCURE trial and provide a rationale for MTX as a non-surgical treatment option in recurrent, therapy-resistant dVIN.
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Wouters et al. (2026) studied this question.
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