Division of Dermatology - IRCSS Azienda Ospedaliero Universitaria di Bologna, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
Pediatr Dermatol. 2021 Sep;38(5):1012-1019. doi: 10.1111/pde.14771. Epub 2021 Sep 24.
Vulvar vitiligo (VV) and vulvar lichen sclerosus (VLS), both feature skin and mucosal hypo-/depigmentation. The aim of this study was to describe the clinical and dermoscopic features of VV and VLS in the pediatric population, providing diagnostic clues, and to define their association. We performed a systematic literature review of the clinical and dermoscopic features of pediatric VV and VLS. An observational study was conducted on children affected by VLS associated with VV, referred to the Dermatology Unit of the Sant'Orsola Polyclinic in Bologna, Italy. Medical history, age at diagnosis, ethnicity, clinical and dermoscopic features, and symptoms were recorded for all patients. 124 cases of VLS and 10 cases of VV were reviewed. Clinical manifestations included hypo-/depigmented patches in both conditions, while ecchymosis/purpura and fissures/erosion were observed in VLS. Symptoms including pruritus, pain, or burning were reported only by VLS patients. In our study five patients with VLS associated with VV were retrieved. Clinical features included well-demarcated depigmented patches in VV and translucent areas, erythema, ecchymoses/purpura, and labial fusion in VLS. Dermoscopy showed white structureless areas with a whipped cream-like appearance, linear or dotted vessels, white chrysalis-like structures, erosion and red-purpuric blotches in VLS and reduced pigment network or pigment absence, intralesional spots of residual pigmentation and telangiectasias in VV. Symptoms were present in all patients. Both VV and VLS show hypo-/depigmented patches. In the presence of associated symptoms, possible VLS should be investigated with clinical and dermoscopic examination to achieve a prompt diagnosis.
外阴白癜（VV）和外阴硬化性苔藓（VLS）均表现为皮肤和黏膜色素减退/脱失。本研究旨在描述儿童外阴白癜和硬化性苔藓的临床和皮肤镜特征，提供诊断线索，并确定它们之间的关联。我们对儿童外阴白癜和硬化性苔藓的临床和皮肤镜特征进行了系统的文献回顾。对意大利博洛尼亚 Sant'Orsola 多学科医院皮肤科就诊的与 VV 相关的 VLS 患儿进行了一项观察性研究。记录了所有患者的病史、诊断年龄、种族、临床和皮肤镜特征以及症状。共回顾了 124 例 VLS 和 10 例 VV 病例。两种疾病的临床表现均为色素减退/脱失斑，而 VLS 可见瘀斑/紫癜和皲裂/糜烂。瘙痒、疼痛或烧灼感等症状仅见于 VLS 患者。在我们的研究中，发现了 5 例与 VLS 相关的 VV 患者。临床特征包括 VV 中边界清楚的色素减退斑和 VLS 中的半透明区域、红斑、瘀斑/紫癜和阴唇融合。皮肤镜下显示 VLS 为白色无结构区域，呈奶油状外观，线状或点状血管，白色蝴蝶状结构，糜烂和红色瘀斑，而 VV 则表现为色素网减少或色素缺失，皮损内残留色素斑点和毛细血管扩张。所有患者均有症状。VV 和 VLS 均表现为色素减退/脱失斑。在存在相关症状的情况下，应通过临床和皮肤镜检查来检查是否存在 VLS，以尽快做出诊断。
