Department of Dermatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
JAMA Dermatol. 2013 Oct;149(10):1199-202. doi: 10.1001/jamadermatol.2013.4885.
Lichen sclerosus (LS) is an uncommon chronic inflammatory disease that most commonly affects anogenital skin of postmenopausal women. It typically manifests as atrophic white plaques, which may be accompanied by purpura or fissuring. Rarely, LS has been observed to affect mucosal tissues in the mouth and the penile urethra. It is generally taught that LS does not affect the vagina, unlike lichen planus. To our knowledge, only one case report of LS with vaginal involvement exists in the literature.
Two cases of severe vulvar LS with vaginal involvement are reported. Both cases exhibited characteristic features of LS on vaginal biopsy, and both patients were followed up clinically without further treatment of the vagina.
Vaginal LS may be more common than previously thought and may be underdiagnosed. Patients with more severe disease or with significant vaginal atrophy may be more likely to have involvement of the vagina. In addition, patients with pelvic organ laxity may be at increased risk if their vaginal walls are chronically exposed because of prolapse. Physicians managing patients with vulvar LS should be aware of the possibility of vaginal involvement so that vaginal lesions may be diagnosed and followed up appropriately.
硬化性苔藓（LS）是一种罕见的慢性炎症性疾病，最常影响绝经后妇女的肛门生殖器皮肤。它通常表现为萎缩性白色斑块，可能伴有紫癜或皲裂。罕见情况下，LS 也会影响口腔和阴茎尿道的粘膜组织。一般认为 LS 不会像扁平苔藓那样影响阴道。据我们所知，文献中仅有一例 LS 伴阴道受累的病例报告。
报告了两例严重外阴 LS 伴阴道受累的病例。这两例阴道活检均显示出 LS 的特征性表现，且这两名患者均在临床上进行了随访，而未对阴道进行进一步治疗。
阴道 LS 可能比以前认为的更为常见，并且可能被误诊。病情更严重或有明显阴道萎缩的患者更有可能出现阴道受累。此外，如果由于脱垂导致阴道壁长期暴露，盆腔器官松弛的患者可能会有更高的风险。管理外阴 LS 患者的医生应意识到阴道受累的可能性，以便诊断和适当随访阴道病变。
