Singh Nilanchali, Ghatage Prafull
Department of Gynecologic Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, Alberta, Canada.
Obstet Gynecol Int. 2020 Apr 21;2020:7480754. doi: 10.1155/2020/7480754. eCollection 2020.
. Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. With numerous controversies as regards to the nomenclature, diagnosis and its association with neoplastic conditions, we decided to conduct a scoping review on this subject. . A review protocol was developed, and the Knowledge Resource Services website was used to do a search of articles pertaining to VLS with keywords "Vulvar," "Vulval," "diagnosis," "lichen sclerosus et atrophicus," "kraurosis," "vulvar dystrophy," and "Lichen Sclerosus". . The search was limited to published data from the last ten years, i.e., from July 2009 onwards and in the English language. A total of 338 articles pertaining to VLS were obtained. Older data were accessed if particular information was sought for. . The presentation is bimodal, i.e., one in prepubertal girls (average age: 7.6 years) and the other in peri- and postmenopausal women (average age: 52.6 years). However, many cases also present during reproductive years. Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local infectious background. It affects the genital labial, perineal, and perianal areas and manifests as a patchy, thin, glistening, ivory-white area. Diagnosis is mainly based on clinical features. Biopsy is seldom required. It has been well established as a precursor lesion of dVIN and vulvar carcinoma.
外阴硬化性苔藓（VLS）是一种慢性炎症性疾病，可影响所有年龄段的女性。鉴于在命名、诊断及其与肿瘤性疾病的关联方面存在众多争议，我们决定对该主题进行一项范围综述。制定了一项综述方案，并使用知识资源服务网站，以“外阴”“女阴”“诊断”“硬化萎缩性苔藓”“干枯病”“外阴营养不良”和“硬化性苔藓”为关键词，搜索与VLS相关的文章。搜索限于过去十年（即从2009年7月起）已发表的数据，且文章语言为英文。共获得338篇与VLS相关的文章。若需要特定信息，则获取更早期的数据。其表现具有双峰性，即在青春期前女孩（平均年龄：7.6岁）和围绝经期及绝经后女性（平均年龄：52.6岁）中各有一个发病高峰。然而，许多病例也出现在生育期。就病因而言，研究表明其起源是多因素的，包括遗传、自身免疫、激素和局部感染背景。它累及阴唇、会阴和肛周区域，表现为片状、变薄、有光泽的象牙白色区域。诊断主要基于临床特征。很少需要活检。它已被确认为分化型外阴上皮内瘤变（dVIN）和外阴癌的前驱病变。
