Department of Dermatology, CHU Rennes, 35033 Rennes cedex 9, France; Study group for anogenital diseases, French Society of Dermatology, Maison de la Dermatologie, 10, cité Malesherbes, 75009 Paris, France.
Study group for anogenital diseases, French Society of Dermatology, Maison de la Dermatologie, 10, cité Malesherbes, 75009 Paris, France; Department of Pathology, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France.
Ann Dermatol Venereol. 2021 Dec;148(4):221-227. doi: 10.1016/j.annder.2021.04.001. Epub 2021 Jul 1.
Recurrent episodes of painful papules and nodules, mostly located on the labia minora, have been reported under the denominations of vulvar sebaceous adenitis (14 published cases) and vulvar acne (16 published cases).
The primary aim of this study was to delve further into the clinical and pathological features of this condition. The secondary aim was to collect therapeutic data.
In this retrospective cohort study, files and photographs of patients with papules or nodules on the labia minora or the inner labia majora were extracted from a vulvar clinic database. Clinical, pathological and therapeutic data were analysed.
Forty-five women were included from 2002 to 2018. The median age at the time of diagnosis was 36 years (range: 16-60). The median time to diagnosis was 6.5 years. Clinical features included recurrent painful papules, pustules or nodules, suppuration (n=22), and pitted scars (n=10) on the labia minora (n=41), the inner labia majora (n=19), the outer labia majora (n=1), and the clitoral hood (n=1). Associated acne vulgaris was seen in 17 out of 26 patients for whom data were available. Hidradenitis suppurativa, androgenic alopecia and hirsutism were observed in 3, 1 and 1 cases respectively. Neutrophilic infiltrates were observed in the 4 available biopsies within or around the Fordyce sebaceous glands in 2 patients. Treatment with tetracyclines and oral zinc was not consistently effective. Isotretinoin led to complete remission in 4 patients unresponsive to tetracyclines.
Vulvar sebaceous adenitis/vulvar acne is a clinically identifiable cause of painful recurrent inflammatory lesions affecting the labia minora and the inner labia majora, which are coincidentally sites of Fordyce granules. We therefore suggest a more specific denomination: "vulvar Fordyce adenitis". The relationship with acne vulgaris and hidradenitis suppurativa requires further investigation. We suggest use of an oral anti-acne therapeutic strategy to reduce inflammation and to decrease the secretion of the sebaceous glands.
反复发作的疼痛性丘疹和结节，主要位于小阴唇，曾被命名为外阴皮脂腺腺瘤（14 例已发表病例）和外阴痤疮（16 例已发表病例）。
本研究的主要目的是进一步研究该疾病的临床和病理特征。次要目的是收集治疗数据。
在这项回顾性队列研究中，从外阴诊所数据库中提取了小阴唇或大阴唇内侧有丘疹或结节的患者的病历和照片。分析了临床、病理和治疗数据。
2002 年至 2018 年期间共纳入 45 名女性。诊断时的中位年龄为 36 岁（范围：16-60 岁）。中位诊断时间为 6.5 年。临床特征包括反复发作的疼痛性丘疹、脓疱或结节、化脓（n=22）和小阴唇（n=41）、大阴唇内侧（n=19）、大阴唇外侧（n=1）和阴蒂包皮（n=1）上的凹陷性瘢痕。有数据可查的 26 名患者中有 17 名患有寻常痤疮。3 名患者患有化脓性汗腺炎，1 名患者患有雄激素性脱发，1 名患者患有多毛症。在 2 名患者的 Fordyce 皮脂腺内或周围的 4 份活检中观察到中性粒细胞浸润。四环素和口服锌的治疗并不总是有效。异维 A 酸对四环素治疗无效的 4 名患者导致完全缓解。
外阴皮脂腺腺瘤/外阴痤疮是一种可识别的临床病因，可引起影响小阴唇和大阴唇内侧的反复发作的疼痛性炎症性病变，而这些部位恰好是 Fordyce 颗粒的所在部位。因此，我们建议使用更具体的名称：“外阴 Fordyce 腺瘤”。与寻常痤疮和化脓性汗腺炎的关系需要进一步研究。我们建议使用口服抗痤疮治疗策略来减少炎症和减少皮脂腺的分泌。
