Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Center for Translational Medicine, Beijing, China.
Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.
Skin Res Technol. 2022 Nov;28(6):780-785. doi: 10.1111/srt.13198. Epub 2022 Aug 15.
Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease initially involving anogenital areas. Noninvasive assessment is essential for precise management in VLS. We aim to analyze high-frequency ultrasound (HFUS) features and correlate HFUS with histopathological changes.
Forty patients with histopathologically confirmed VLS lesions were retrospectively identified from August 2020 to September 2021. The clinical manifestations, dermoscopic images as well as both 20 and 50 MHz HFUS images were assessed. HFUS assessment included epidermal morphology, hypoechoic dermal band thickness, and hypoechoic dermal band internal echo. We compared HFUS images with histopathology, and Pearson's correlation coefficient was used to assess the relationship between hypoechoic dermal band thickness and histopathological depth.
Hypoechoic dermal band was present in 100% (40/40) VLS lesions. There was a significant linear positive correlation between the histopathological depth and corresponding hypoechoic dermal band thickness, with a Pearson correlation coefficient of 0.685 (p < 0.001). Besides, 95% (38/40) lesions revealed smooth epidermis, and the internal echo of hypoechoic dermal band was assessed as homogeneous in 60% (24/40) and inhomogeneous in 40% (16/40) lesions.
HFUS characteristics, as well as measurable hypoechoic dermal band thickness, may provide valuable information in the precise diagnosis and the treatment monitoring of VLS.
外阴硬化性苔藓（VLS）是一种慢性炎症性疾病，最初涉及外阴和肛周区域。非侵入性评估对于 VLS 的精确管理至关重要。我们旨在分析高频超声（HFUS）特征，并将 HFUS 与组织病理学变化相关联。
从 2020 年 8 月至 2021 年 9 月，回顾性地从组织病理学证实的 VLS 病变患者中确定了 40 名患者。评估了临床表现、皮肤镜图像以及 20MHz 和 50MHz HFUS 图像。HFUS 评估包括表皮形态、低回声真皮带厚度和低回声真皮带内部回声。我们将 HFUS 图像与组织病理学进行比较，并使用 Pearson 相关系数评估低回声真皮带厚度与组织病理学深度之间的关系。
100%（40/40）的 VLS 病变存在低回声真皮带。组织病理学深度与相应的低回声真皮带厚度之间存在显著的线性正相关，Pearson 相关系数为 0.685（p<0.001）。此外，95%（38/40）的病变显示光滑的表皮，60%（24/40）的低回声真皮带内部回声评估为均匀，40%（16/40）的低回声真皮带内部回声评估为不均匀。
HFUS 特征以及可测量的低回声真皮带厚度可能为 VLS 的精确诊断和治疗监测提供有价值的信息。
