Kaur Jasleen, Kalsy Jyotika
Department of Dermatology, Venereology, Leprosy, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.
Department of Dermatology, Venereology, Leprosy, Government Medical College, Amritsar, Punjab, India.
Indian J Sex Transm Dis AIDS. 2017 Jan-Jun;38(1):15-21. doi: 10.4103/0253-7184.192632.
According to the World Health Organization criteria, geriatric population is people above 60 years of age. In this phase of life, a woman has already gone through menopause and its associated emotional, physical, and hormonal changes. These changes are due to gradual loss of estrogen that comes with menopause which results in dramatic changes in the appearance of vulva and vagina. With age, skin of vulva becomes thin, loses elasticity, and moisture so that the patient starts feeling burning and itchy sensation. The normal acidic pH changes to basic which alters the flora and makes the person prone to other bacterial infections. Apart from infections, there are many other dermatological and nondermatological causes of vulvar itching in this age group such as eczema, contact dermatitis, lichen planus (LP), lichen sclerosus atrophicans, lichen simplex chronicus (LSC), prolapse, incontinence, and carcinoma. The aim is to diagnose the causes of pruritus vulvae in the geriatric age group to decrease the misery of these patients.
We selected 40 consecutive females of age group ranging from 60 to 75 years coming to skin OPD with the complaint of pruritus of vulvar region over a period of 1 year. Clinical examination, complete blood count, fasting blood sugar, wet mount, pap smear, and skin biopsy were done in every case.
Out of the forty patients who were included in this study, 17 (42.5%) were diagnosed as a case of LSC and 11 (27.5%) patients had atrophic vaginitis. Three (7.5%) patients presented with tinea. Three (7.5%) cases were clinically diagnosed as scabies. Another 2 (5%) cases were diagnosed as LP and was seen in other 2 (5%) cases. 1 (2.5%) case was diagnosed as bacillary vaginosis and 1 (2.5%) patient was of lichen sclerosus.
Pruritus vulvae of geriatric age group are of diverse etiology, therefore, treatment based on precise diagnosis is of prime importance.
根据世界卫生组织的标准，老年人口是指60岁以上的人群。在这个生命阶段，女性已经经历了更年期及其相关的情绪、身体和激素变化。这些变化是由于更年期伴随的雌激素逐渐丧失，这导致外阴和阴道外观发生显著变化。随着年龄的增长，外阴皮肤变薄，失去弹性和水分，患者开始感到灼烧和瘙痒感。正常的酸性pH值变为碱性，这改变了菌群，使患者容易受到其他细菌感染。除了感染，这个年龄组外阴瘙痒还有许多其他皮肤病学和非皮肤病学原因，如湿疹、接触性皮炎、扁平苔藓（LP）、萎缩性硬化苔藓、慢性单纯性苔藓（LSC）、脱垂、尿失禁和癌。目的是诊断老年年龄组外阴瘙痒的原因，以减轻这些患者的痛苦。
我们选择了40名年龄在60至75岁之间的连续女性，她们在1年的时间里因外阴瘙痒前来皮肤科门诊就诊。对每个病例都进行了临床检查、全血细胞计数、空腹血糖、湿片检查、巴氏涂片和皮肤活检。
在纳入本研究的40名患者中，17例（42.5%）被诊断为LSC，11例（27.5%）患者患有萎缩性阴道炎。3例（7.5%）患者出现癣。3例（7.5%）病例临床诊断为疥疮。另外2例（5%）病例被诊断为LP，另有2例（5%）病例出现这种情况。1例（2.5%）病例被诊断为细菌性阴道病，1例（2.5%）患者患有硬化苔藓。
老年年龄组外阴瘙痒病因多样，因此，基于精确诊断的治疗至关重要。
