Division of General Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Women's Health Team, Fenway Health, Boston, MA, USA.
J Gen Intern Med. 2013 Apr;28(4):592-5. doi: 10.1007/s11606-012-2209-z. Epub 2012 Sep 7.
Lichen sclerosus is a commonly misdiagnosed disease that is characterized by thinned, hypopigmented, crinkled skin that often forms a figure-eight shape around the vaginal and anal openings. We present a case of advanced lichen sclerosus in a 53-year-old female patient prescribed a nonsteroidal aromatase inhibitor after the excision of a breast cancer tumor. We present a diagnostic approach to lichen sclerosus by recognizing its common figure-eight pattern, and we review the known causes and treatment of lichen sclerosus. Research has shown that lichen sclerosus is more common in low estrogen states, and thus it is logical that aromatase inhibitors could increase a patient's risk for developing this disease. We therefore propose that all patients prescribed aromatase inhibitors undergo regular vulvo-vaginal exams to rule out lichen sclerosus and other hypoestrogen-related vulvo-vaginal problems.
硬化性苔藓是一种常被误诊的疾病，其特征是皮肤变薄、色素减退、起皱，常常在阴道和肛门开口处形成一个数字“8”的形状。我们报告了一例 53 岁女性患者的晚期硬化性苔藓病例，该患者在切除乳腺癌肿瘤后被开处了非甾体类芳香酶抑制剂。我们通过识别其常见的数字“8”模式提出了硬化性苔藓的诊断方法，并回顾了硬化性苔藓的已知病因和治疗方法。研究表明，硬化性苔藓在低雌激素状态下更为常见，因此芳香酶抑制剂会增加患者患这种疾病的风险是合乎逻辑的。因此，我们建议所有开处芳香酶抑制剂的患者定期进行外阴阴道检查，以排除硬化性苔藓和其他与低雌激素相关的外阴阴道问题。
