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三级转诊中心的硬化性苔藓及相关合并症管理:超越局部类固醇治疗

Management of Lichen Sclerosus and Related Comorbidities at a Tertiary Referral Center: Beyond Topical Steroids.

作者信息

Paganelli Alessia, Contu Luca, Ficarelli Elena, Garbarino Federico, Motolese Alberico

机构信息

Dermatology Unit, Arcispedale S. Maria Nuova, Reggio Emilia Research Hospital, Azienda Unità Sanitaria Locale IRCCS of Reggio Emilia, Italy.

出版信息

Dermatol Pract Concept. 2024 Oct 30;14(4):e2024262. doi: 10.5826/dpc.1404a262.

Abstract

INTRODUCTION

Lichen sclerosus (LS) is a chronic inflammatory dermatosis predominantly affecting the anogenital area, with potential systemic implications.

OBJECTIVE

Our aim was to elucidate its clinical characteristics and management strategies.

METHODS

We conducted a retrospective observational study on adult patients with LS referred to our center between January 2022 and December 2023.

RESULTS

Forty-six adult subjects affected with LS were enrolled in the present study. The majority of patients presented with genital involvement, but a significant subset also exhibited extragenital LS and concomitant immune-mediated disorders. Common symptoms included itching, soreness, and dyspareunia, with characteristic skin findings of erythema and atrophy. Topical corticosteroids were the mainstay of therapy, complemented by alternative treatments in refractory cases. Alternative therapeutic approaches, such as PRP (platelet rich plasma) or ADSC (adipose-tissue derived stromal/stem cell)-based strategies, were effectively employed in refractory cases, in the absence of major adverse events.

CONCLUSIONS

Our findings underscore the importance of alternative approaches in the management of LS and highlight the need for further research to elucidate its pathogenesis and optimize therapeutic interventions.

摘要

引言

硬化性苔藓(LS)是一种主要累及肛门生殖器区域的慢性炎症性皮肤病,可能具有全身影响。

目的

我们的目的是阐明其临床特征和管理策略。

方法

我们对2022年1月至2023年12月期间转诊至我们中心的成年LS患者进行了一项回顾性观察研究。

结果

本研究纳入了46名患有LS的成年受试者。大多数患者表现为生殖器受累,但相当一部分患者也表现为生殖器外的LS以及伴发的免疫介导性疾病。常见症状包括瘙痒、疼痛和性交困难,具有红斑和萎缩等特征性皮肤表现。外用糖皮质激素是主要治疗方法,难治性病例则辅以替代治疗。在难治性病例中有效采用了替代治疗方法,如富血小板血浆(PRP)或基于脂肪组织来源的基质/干细胞(ADSC)的策略,且未出现重大不良事件。

结论

我们的研究结果强调了替代方法在LS管理中的重要性,并突出了进一步研究以阐明其发病机制和优化治疗干预措施的必要性。

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本文引用的文献

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Immunologic and nonimmunologic sclerodermal skin conditions - review.免疫性和非免疫性硬皮病皮肤状况——综述。
Front Immunol. 2023 Jul 12;14:1180221. doi: 10.3389/fimmu.2023.1180221. eCollection 2023.
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Lichen sclerosus: The 2023 update.硬化性苔藓:2023年更新版
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