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外用糖皮质激素治疗后外阴硬化性苔藓的临床及皮肤镜变化

Clinical and dermoscopic changes of vulvar lichen sclerosus after topical corticosteroid treatment.

作者信息

Borghi Alessandro, Corazza Monica, Minghetti Sara, Toni Giulia, Virgili Annarosa

机构信息

Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy.

出版信息

J Dermatol. 2016 Sep;43(9):1078-82. doi: 10.1111/1346-8138.13374. Epub 2016 Apr 14.

Abstract

With the aim to assess changes in both clinical and dermoscopic features of vulvar lichen sclerosus (VLS) after a treatment with topical corticosteroid, 29 VLS patients treated with mometasone furoate 0.1% ointment for 12 weeks were evaluated for symptoms, objective signs and dermoscopic variables at baseline and treatment completion. Numeric scores were assigned to each parameter. Mean itching and burning values had decreased significantly at the 12-week control visit compared with baseline, as well as values referring to pallor, hyperkeratosis and purpuric lesions. Among the dermoscopic variables, the vessel score increased while the scores of patchy, structureless, whitish areas, whitish background, purpuric globules and scales decreased significantly after treatment. Scores referring to gray-blue dots, comedo-like openings and structures like ice slivers did not change significantly throughout the treatment. Based on these findings, dermoscopic features may change, even significantly, with topical corticosteroids and may be useful for monitoring the response to treatment.

摘要

为了评估外用皮质类固醇治疗后外阴硬化性苔藓(VLS)临床和皮肤镜特征的变化,对29例外用0.1%糠酸莫米松软膏治疗12周的VLS患者在基线和治疗结束时进行了症状、客观体征和皮肤镜变量评估。为每个参数分配了数值评分。与基线相比,在12周的对照访视时,平均瘙痒和灼痛值以及与苍白、角化过度和紫癜性病变相关的值均显著降低。在皮肤镜变量中,治疗后血管评分增加,而斑片状、无结构、白色区域、白色背景、紫癜性小球和鳞屑的评分显著降低。在整个治疗过程中,与灰蓝色点、粉刺样开口和冰屑样结构相关的评分没有显著变化。基于这些发现,皮肤镜特征可能会因外用皮质类固醇而发生变化,甚至显著变化,并且可能有助于监测治疗反应。

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