Šuler Baglama Špela, Jemec Gregor B E, Zmazek Jan, Trčko Katarina
Clinic of Dermatovenereology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Department of Dermatology, Zealand University Hospital, Roskilde, Denmar; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Acta Derm Venereol. 2024 Aug 7;104:adv39982. doi: 10.2340/actadv.v104.39982.
The comorbidities of lichen sclerosus (LS) are presumed but have not been analysed in detail. The purpose of this review was to identify evidence-based associated diseases in patients with LS and explore the potential need for sex-dependent screening protocols. A comprehensive search of the MEDLINE, Embase, and PsycINFO databases from inception to 29 February 2024 was conducted using the key search terms LS and all its synonyms. Pooled odds ratios and 95% confidence intervals of comorbidities were generated using the DerSimonian and Laird random-effects model. A total of 21 case-control studies met the inclusion criteria. Of the 75 comorbidities analysed, only 16 (21.3%) were studied in both sexes, revealing no contrasting associations based on sex. Both female and male LS patients showed significantly increased odds of common dermatological conditions (i.e., lichen planus, vitiligo, alopecia areata, atopic dermatitis, and psoriasis), various cardiovascular risk factors (i.e., essential hypertension, obesity, dyslipidaemia, diabetes mellitus, and diabetes mellitus type 2), genital warts, and hypothyroidism compared with controls. Overall, the scarcity of data currently does not support the implementation of sex-dependent screening strategies. The findings do, however, present significant associations with a range of potentially serious comorbidities, which warrants further elucidation and clinical vigilance.
硬化性苔藓（LS）的合并症是推测出来的，但尚未进行详细分析。本综述的目的是确定LS患者中基于证据的相关疾病，并探讨性别依赖性筛查方案的潜在需求。使用关键词LS及其所有同义词，对MEDLINE、Embase和PsycINFO数据库从创建到2024年2月29日进行了全面检索。使用DerSimonian和Laird随机效应模型生成合并症的合并比值比和95%置信区间。共有21项病例对照研究符合纳入标准。在分析的75种合并症中，只有16种（21.3%）在两性中都进行了研究，未发现基于性别的对比关联。与对照组相比，女性和男性LS患者出现常见皮肤病（即扁平苔藓、白癜风、斑秃、特应性皮炎和银屑病）、各种心血管危险因素（即原发性高血压、肥胖、血脂异常、糖尿病和2型糖尿病）、尖锐湿疣和甲状腺功能减退的几率均显著增加。总体而言，目前数据的匮乏不支持实施性别依赖性筛查策略。然而，研究结果确实表明与一系列潜在的严重合并症存在显著关联，这值得进一步阐明和临床警惕。
