Tasker G L, Wojnarowska F
Department of Dermatology, Oxford Radcliffe Hospital, Oxford, UK.
Clin Exp Dermatol. 2003 Mar;28(2):128-33. doi: 10.1046/j.1365-2230.2003.01211.x.
Lichen sclerosus is a chronic skin condition, which offers many challenges to the clinician. It affects men, women and children, and usually occurs in the anogenital area. The clinical signs can be confused with those seen in sexual abuse in children. The underlying cause is unknown; however, there is a strong association with autoimmune disorders, and immunogenetic studies have demonstrated a link with HLA DQ7. Patients suffer significant morbidity as a consequence of the intractable symptoms, physical scarring and psychosexual damage. Support groups may be helpful for some patients. Potent topical corticosteroids have been shown to be effective. There is a 5% incidence of squamous cell carcinoma, and all suspicious lesions should be biopsied. It is unclear whether the risk of malignancy is changed with the use of topical corticosteroids, as there is a potential risk of triggering a latent infection of human papillomavirus. A multidisciplinary approach to care is required and ideally all patients should attend a dedicated clinic and be offered long-term monitoring.
硬化性苔藓是一种慢性皮肤病，给临床医生带来诸多挑战。它可影响男性、女性和儿童，通常发生于肛门生殖器部位。其临床症状可能与儿童性虐待的症状相混淆。病因不明；然而，它与自身免疫性疾病密切相关，免疫遗传学研究已证实其与HLA DQ7存在关联。由于症状难以治愈、身体瘢痕形成以及心理性损伤，患者承受着巨大痛苦。支持小组对部分患者可能有所帮助。强效外用糖皮质激素已被证明有效。鳞状细胞癌的发病率为5%，所有可疑病变均应进行活检。目前尚不清楚使用外用糖皮质激素是否会改变恶性肿瘤风险，因为存在引发人乳头瘤病毒潜伏感染的潜在风险。需要采取多学科护理方法，理想情况下，所有患者都应前往专门诊所并接受长期监测。
