Department of Dermatology, Royal North Shore Hospital, St Leonards, Sydney, Australia.
J Low Genit Tract Dis. 2012 Oct;16(4):364-71. doi: 10.1097/LGT.0b013e31824b9e5e.
There are limited data on psoriasis as it affects the vulva in the medical literature. This observational study aimed to describe the symptoms, signs, and management of vulvar psoriasis in adults and children in a private vulvar disease referral practice.
A review of the existing literature on vulvar psoriasis was used to generate inclusion criteria of a chronic noninfective erythematous vulvitis without vaginal involvement. Between January 2009 and October 2011, 201 patients presenting with these criteria were coded as having psoriasis in a computerized database where standardized data were collected. In 194 of these patients, adequate data were available to include in the study.
Only 12.3% of the patients presented with psoriasis as a provisional diagnosis with a mean symptom duration of 4.5 years (range = 6 weeks to 35 years). The most common presentation was a pruritic, bilaterally symmetrical, erythematous, nonscaly, well-demarcated macular eruption or slightly raised plaque (82.5%). Of the remaining patients, 9.2% presented with only diffuse symptomatic erythema, whereas 8.2% were symptomatic without erythema. In 64.9% of the patients, evidence of psoriasis was found on other parts of the skin. Initial induction treatment with potent topical corticosteroid followed by a maintenance treatment with less potent topical steroids and other psoriasis-specific treatment such as tar creams and calcipotriol resulted in a suppression of disease in 93.8% of the patients during a mean follow-up duration of 8.9 months (range = 1 month to 7.25 years).
Vulvar psoriasis is a difficult diagnosis that should be considered in patients presenting with a chronic erythematous vulvitis without vaginitis. It is a chronic relapsing skin condition that requires long-term management.
医学文献中关于外阴银屑病的资料有限。本观察性研究旨在描述私人外阴疾病转诊机构中成人和儿童外阴银屑病的症状、体征和治疗方法。
回顾外阴银屑病的现有文献，生成包括慢性非传染性红斑性外阴炎且无阴道受累的纳入标准。2009 年 1 月至 2011 年 10 月，符合这些标准的 201 例患者在计算机数据库中被编码为患有银屑病，其中收集了标准化数据。在这 201 例患者中，有 194 例患者的数据足够纳入研究。
只有 12.3%的患者以暂定诊断为银屑病就诊，平均症状持续时间为 4.5 年（范围为 6 周至 35 年）。最常见的表现是瘙痒、双侧对称、红斑、非鳞屑、边界清楚的斑疹或轻度隆起的斑块（82.5%）。其余患者中，9.2%仅表现为弥漫性症状性红斑，而 8.2%有症状但无红斑。在 64.9%的患者中，其他皮肤部位发现了银屑病的证据。初始诱导治疗采用强效外用皮质类固醇，然后采用弱效外用类固醇和其他银屑病特异性治疗，如焦油霜和卡泊三醇，在平均 8.9 个月（范围为 1 个月至 7.25 年）的随访期间，93.8%的患者疾病得到抑制。
外阴银屑病是一种难以诊断的疾病，对于出现慢性红斑性外阴炎且无阴道炎的患者应考虑该病。它是一种慢性复发性皮肤病，需要长期管理。
