Department of Dermatology, Beijing Hospital, National Center of Gerontology, Beijing, China.
J Dermatol. 2018 Sep;45(9):1101-1104. doi: 10.1111/1346-8138.14533. Epub 2018 Jul 9.
Vulvar lichen sclerosus (VLS) is an uncommon, chronic inflammatory skin disease lacking clinical data of large sample size in China. This study was intended to provide missing data on this condition through investigating the clinical characteristics of Chinese VLS patients. The medical records of 129 VLS patients from our vulvar outpatient clinic were analyzed with SPSS version 18.0 software. The age of onset followed a normal distribution, with the peak at 25-30 years. Of all cases, the incidence rate during the postmenopausal period was 14.0% with an average duration of 9.22 years. The most frequently involved site was the bilateral labia minora (71.3%). Itching was the principal symptom (94.6%); meanwhile, patients with severe itching more commonly experienced longer duration, flaring at night, hyperkeratotic lesions or rashes on the posterior commissure than those with mild to moderate itching (P < 0.05). Furthermore, 60% of the enrolled patients suffered from sexual dysfunction. The major sign was pallor (92.2%), followed by hyperkeratosis (55.0%) and atrophy (40.3%). The patients with atrophy had a significantly longer duration of the disease, and the older patients presented more frequently with edema in the area of lesions (both P < 0.05). Of our patients, 9.3% suffered concomitantly from autoimmune diseases, mostly thyroid with one case being complicated by vulvar squamous cell carcinoma (SCC). In our study, the severity of pruritus was partly related to clinical manifestations. Moreover, Chinese patients could have developed VLS mostly in the reproductive period, with less complications of autoimmune diseases or SCC.
外阴硬化性苔藓(VLS)是一种少见的慢性炎症性皮肤病,中国缺乏大样本的临床数据。本研究旨在通过调查中国 VLS 患者的临床特征来填补这一空白。使用 SPSS 18.0 软件分析了 129 例外阴门诊 VLS 患者的病历。发病年龄呈正态分布,高峰在 25-30 岁。所有病例中,绝经后发病占 14.0%,平均病程 9.22 年。最常累及的部位是双侧小阴唇(71.3%)。瘙痒是主要症状(94.6%);同时,严重瘙痒的患者较轻度至中度瘙痒的患者更常见夜间发作、角化过度病变或后联合皮疹(P<0.05)。此外,60%的患者患有性功能障碍。主要体征为苍白(92.2%),其次是角化过度(55.0%)和萎缩(40.3%)。有萎缩的患者疾病病程明显较长,病变部位的老年患者更常出现水肿(均 P<0.05)。我们的患者中有 9.3%同时患有自身免疫性疾病,主要是甲状腺疾病,有一例并发外阴鳞状细胞癌(SCC)。在本研究中,瘙痒的严重程度部分与临床表现有关。此外,中国患者 VLS 的发病主要在生育期,自身免疫性疾病或 SCC 的并发症较少。