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[已确诊的生殖器和生殖器外硬化性苔藓:临床病理分析]

[Established Genital and Extragenital Lichen Sclerosus:A Clinicopathological Analysis].

作者信息

Lü Jiaqi, Chang Jian-Min

机构信息

National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences, Department of Dermatology,Beijing Hospital,Beijing 100730,China.

Graduate School,CAMS and PUMC,Beijing 100730,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Dec 30;43(6):849-855. doi: 10.3881/j.issn.1000-503X.13817.

Abstract

Objective To investigate the clinicopathological characteristics of established genital and extragenital lichen sclerosus(LS)and compare the differences between them. Method The clinicopathological data of 55 patients with established genital and extragenital LS diagnosed by pathological examination in the Department of Dermatology of Beijing Hospital were retrospectively analyzed. Results The 55 patients included 11 males and 44 females.Among them,38,15,and 2 patients had genital lesions,extragenital lesions,and both genital and extragenital lesions,respectively.Extragenital LS mainly involved the back(14.55%)and extremities(7.27%).Among the patients,28.30% were asymptomatic,and 73.58% and 24.53% felt itchy and painful,respectively.The asymptomatic patients had a higher proportion in extragenital cases(=31.224,=0.000),and the itchy symptom was more common in genital LS cases than in extragenital LS cases(=39.073,=0.000).Vulvar pain only appeared in the patients with genital LS.A total of 57 biopsy specimens from the 55 patients were reviewed,of which 40 were from genital lesions and 17 were from extragenital lesions.In addition to papillary dermal homogenization (100%),the common pathological changes include hyperkeratosis(98.25%),atrophy(50.88%),basal cell liquefaction degeneration (52.63%),dilated blood vessels(64.91%),a perivascular lymphocytic infiltrate(100%),histiocytic infiltrate(85.96%),and lichenoid inflammatory infiltrate(54.39%).Higher proportions of acanthosis (=4.402,=0.036),dilated blood vessels (=9.330,=0.002),and eosinophilic infiltrate (=4.162,=0.041) were observed in genital LS cases.A higher proportion of follicular plugging appeared in extragenital LS cases (=5.076,=0.024). Conclusion The established genital LS and extragenital LS showed some differences in clinical symptoms and pathological changes including acanthosis,dilated blood vessels,eosinophilic infiltrate,and follicular plugging.

摘要

目的 探讨确诊的生殖器及生殖器外硬化性苔藓(LS)的临床病理特征,并比较两者之间的差异。方法 回顾性分析北京医院皮肤科经病理检查确诊的55例生殖器及生殖器外LS患者的临床病理资料。结果 55例患者中男性11例,女性44例。其中,38例、15例和2例患者分别有生殖器病变、生殖器外病变以及生殖器和生殖器外均有病变。生殖器外LS主要累及背部(14.55%)和四肢(7.27%)。患者中,28.30%无症状,73.58%和24.53%分别有瘙痒和疼痛症状。无症状患者在生殖器外病例中的比例更高(χ²=31.224,P=0.000),瘙痒症状在生殖器LS病例中比在生殖器外LS病例中更常见(χ²=39.073,P=0.000)。外阴疼痛仅出现在生殖器LS患者中。对55例患者的57份活检标本进行了复查,其中40份来自生殖器病变,17份来自生殖器外病变。除乳头层真皮均质化(100%)外,常见的病理变化包括角化过度(98.25%)、萎缩(50.88%)、基底细胞液化变性(52.63%)、血管扩张(64.91%)、血管周围淋巴细胞浸润(100%)、组织细胞浸润(85.96%)和苔藓样炎性浸润(54.39%)。生殖器LS病例中棘层增厚(χ²=4.402,P=0.036)、血管扩张(χ²=9.330,P=0.002)和嗜酸性粒细胞浸润(χ²=4.162,P=0.041)的比例更高。生殖器外LS病例中毛囊堵塞的比例更高(χ²=5.076,P=0.024)。结论 确诊的生殖器LS和生殖器外LS在临床症状和病理变化方面存在一些差异,包括棘层增厚、血管扩张、嗜酸性粒细胞浸润和毛囊堵塞。

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