Jerkovic Gulin Sandra, Liljeberg Linnea, Seifert Oliver
Department of Dermatology and Venereology, Ryhov County Hospital, Sjukhusgatan, Jönköping, Sweden.
Division of Cell Biology, Department of Biomedical and Clinical Sciences, The Faculty of Medicine and Health Sciences Linkoping University, Linköping, Sweden.
Int J Womens Dermatol. 2024 Jan 18;10(1):e131. doi: 10.1097/JW9.0000000000000131. eCollection 2024 Mar.
Genital lichen sclerosus (LS) is a chronic inflammatory skin disorder that affects both sexes of all ages. The clinical characteristics include erosions, redness, and white plaques with atrophic skin, with symptoms such as pruritus, pain, dysuria, and dyspareunia.
This prospective cohort study aimed to assess quality of life (QoL) in men and women with genital LS, both before and after treatment, using the Dermatology Quality of Life Index (DLQI) questionnaire.
Patients diagnosed with genital LS were enrolled continuously in the study and were asked to complete the DLQI questionnaire before treatment and again after individualized treatment 12 weeks apart.
This study included 136 patients (48 females and 88 males) diagnosed with genital LS, with a median age of 62 years (range 18-86). The results showed a statistically significant decrease ( < .001) in DLQI score before treatment (median 6.0 [interquartile range (IQR), 1.0-11.0]) compared to after treatment (median 2.0 [IQR, 0.0-4.0)]. In males and females, the median DLQI scores before treatment were 3.0 (IQR, 0.0-10.0) and 8.0 (IQR, 4.5-11.5), respectively, and after treatment were 1.0 (IQR, 0.0-3.0) and 4.0 (IQR, 0.0-9.0), respectively. Females scored significantly higher ( < .001) than males.
The study's limited generalizability stems from a small sample size of 136 patients, potentially restricting the application of findings to a broader population with genital lichen sclerosus. Additionally, the 12-week follow-up period may not adequately capture the long-term effects of interventions on quality of life. Reliance on self-reported data through the DLQI questionnaire introduces the possibility of bias, as participants may not accurately represent their symptoms and quality of life. The absence of a control group hinders the ability to attribute observed changes solely to the treatment, and the lack of detail on specific interventions makes it challenging to assess the effectiveness of individualized treatment approaches. The wide age range among participants (18-86 years) introduces potential confounding variables, as different age groups may respond differently to treatment.
The study findings confirmed that individuals with genital LS experience a small decline in QoL, as observed in both males and females. This study also highlights that effective management of genital LS can significantly improve QoL in both sexes.
生殖器硬化性苔藓（LS）是一种慢性炎症性皮肤病，可影响各年龄段的男性和女性。临床特征包括糜烂、发红以及伴有皮肤萎缩的白色斑块，伴有瘙痒、疼痛、排尿困难和性交困难等症状。
这项前瞻性队列研究旨在使用皮肤病生活质量指数（DLQI）问卷评估生殖器LS男性和女性在治疗前后的生活质量（QoL）。
连续招募被诊断为生殖器LS的患者，并要求他们在治疗前以及个体化治疗12周后再次完成DLQI问卷。
本研究纳入了136例被诊断为生殖器LS的患者（48名女性和88名男性），中位年龄为62岁（范围18 - 86岁）。结果显示，与治疗后（中位数2.0 [四分位间距（IQR），0.0 - 4.0]）相比，治疗前DLQI评分有统计学显著下降（< 0.001）（中位数6.0 [IQR，1.0 - 11.0]）。在男性和女性中，治疗前DLQI评分的中位数分别为3.0（IQR，0.0 - 10.0）和8.0（IQR，4.5 - 11.5），治疗后分别为1.0（IQR，0.0 - 3.0）和4.0（IQR，0.0 - 9.0）。女性得分显著高于男性（< 0.001）。
该研究的普遍适用性有限，源于样本量较小，仅136例患者，这可能限制了研究结果在更广泛的生殖器硬化性苔藓患者群体中的应用。此外，12周的随访期可能无法充分捕捉干预措施对生活质量的长期影响。通过DLQI问卷依赖自我报告数据存在偏差的可能性，因为参与者可能无法准确反映其症状和生活质量。缺乏对照组阻碍了仅将观察到的变化归因于治疗的能力，并且缺乏具体干预措施的详细信息使得评估个体化治疗方法的有效性具有挑战性。参与者年龄范围较广（18 - 86岁）引入了潜在的混杂变量，因为不同年龄组对治疗的反应可能不同。
研究结果证实，生殖器LS患者的生活质量有小幅下降，男性和女性均如此。本研究还强调，有效管理生殖器LS可显著改善两性的生活质量。
