Day Tania, Bohl Tanja Gizela, Scurry James
Maternity and Gynaecology, John Hunter Hospital, Newcastle, New South Wales.
University of Newcastle, Newcastle, New South Wales.
Australas J Dermatol. 2016 Aug;57(3):210-5. doi: 10.1111/ajd.12308. Epub 2015 Mar 6.
To determine the diagnostic range of lichen dermatoses of the perianus, their extent, and response to treatment.
We reviewed perianal biopsies submitted to a tertiary referral pathology service between January 2010 and July 2014, interpreted as 'lichen' or 'lichenoid'. We collected data on patients' characteristics, referring specialty, extent of lesion and response to treatment.
During the study period, 60 perianal biopsies met our inclusion criteria. The distribution of diagnoses was lichen sclerosus (LS) in 25/60 (42%), lichen simplex chronicus (LSC) in 23/60 (38%), lichen planus (LP) in 10/60 (17%), and a non-specific lichenoid reaction in 2/60 (3%). Eleven of 25 cases of LS (44%) showed superimposed LSC. Of 10 LP cases, nine (90%) were hypertrophic and three of these showed pseudoepitheliomatous hyperplasia; none were erosive LP. Compared with patients in the LS and LSC groups, those with LP were more likely to have a localised lesion. Topical steroids were prescribed in 91% cases with treatment data available, and 98% of treated patients who returned for follow up had improved or their disease was resolved.
We encountered a spectrum of perianal lichen dermatoses, with LS, LP and LSC all represented. LS biopsied at the perianus is often lichenified. Hypertrophic LP is a common form of LP at the perianus.
确定肛周苔藓样皮肤病的诊断范围、病变程度及对治疗的反应。
我们回顾了2010年1月至2014年7月间提交至三级转诊病理科的肛周活检病例，这些病例被诊断为“苔藓”或“苔藓样”。我们收集了患者特征、转诊专科、病变程度及治疗反应的数据。
在研究期间，60例肛周活检符合我们的纳入标准。诊断分布为：硬化性苔藓（LS）25/60（42%），慢性单纯性苔藓（LSC）23/60（38%），扁平苔藓（LP）10/60（17%），非特异性苔藓样反应2/60（3%）。25例LS中有11例（44%）合并LSC。10例LP中，9例（90%）为肥厚性，其中3例显示假上皮瘤样增生；均无糜烂性LP。与LS和LSC组患者相比，LP患者更易出现局限性病变。91%有治疗数据的病例使用了外用类固醇，98%接受治疗并复诊的患者病情改善或痊愈。
我们遇到了一系列肛周苔藓样皮肤病，包括LS、LP和LSC。肛周活检的LS常呈苔藓化。肥厚性LP是肛周LP的常见形式。
