Torres Anna, Grywalska Ewelina, Bartosińska Joanna, Brodowska Joanna, Pycka Joanna, Grimshaw Alyssa, Vash-Margita Alla
Department of Pediatric and Adolescent Gynecology, Medical University of Lublin, Lublin, Poland
Department of of Experimental Immunology, Medical University of Lublin, Lublin, Poland.
BMJ Open. 2025 Jul 20;15(7):e102598. doi: 10.1136/bmjopen-2025-102598.
Paediatric vulval lichen sclerosus (VLS) is a chronic disease with distressing symptoms and severe consequences when left untreated. Majority of existing data on pathophysiology and treatment is based on studies conducted among adult patients. Whereas the course of VLS, its symptomatology and prognosis are distinct to some extent in paediatric and adolescent patients as compared with adults. The purpose of this scoping review is to systematically examine what symptoms of VLS are typical of paediatric and adolescent patients, how often specific signs and symptoms are reported in the literature, if there are differences between paediatric and adolescent patients and what could be the implication of such differences.
This scoping review will adopt the methodology for Joanna Briggs Institute scoping reviews and will consider studies that include female patients aged 1-18, with VLS symptoms and signs with no exclusion based on ethnicity, comorbidity or previous history of treatment. Studies on any aspect of paediatric VLS, including pathogenesis, diagnosis and treatment, which included patients and reported patients' symptoms and signs, will be considered eligible. There will be no geographical or cultural limitation applied in relation to this scoping review. The search will include Embase, Academic Search Premier, CINAHL, Cochrane Library, Google Scholar, Health Source, Ovid Embase, Ovid Medline, PubMed, Scopus and Web of Science Principal Collection. A critical synthesis and results will be presented in the final review as tables and accompanying narrative summary.
Ethical approval is not required for this review. To date, no systematic approaches were undertaken to classify symptoms of the VLS that would aid in formulating disease severity criteria adequate for the paediatric population. We believe that the results of this review will facilitate the development of disease severity scales that could aid in intraindividual and interindividual comparability, both in real-life settings and clinical trials.
小儿外阴硬化性苔藓(VLS)是一种慢性疾病,若不治疗,症状令人痛苦且后果严重。现有的关于病理生理学和治疗的大多数数据基于对成年患者的研究。然而,与成年人相比,小儿和青少年患者的VLS病程、症状表现及预后在一定程度上有所不同。本综述的目的是系统地研究VLS在小儿和青少年患者中的典型症状、文献中特定体征和症状的报告频率、小儿和青少年患者之间是否存在差异以及这些差异可能意味着什么。
本综述将采用乔安娜·布里格斯研究所综述的方法,并将纳入年龄在1至18岁、有VLS症状和体征的女性患者的研究,不基于种族、合并症或既往治疗史进行排除。关于小儿VLS任何方面的研究,包括发病机制、诊断和治疗,只要纳入了患者并报告了患者的症状和体征,都将被视为合格。本次综述在地域或文化方面没有限制。检索将包括Embase、学术搜索高级版、护理及健康领域数据库(CINAHL)、考科蓝图书馆、谷歌学术、健康资源库、Ovid Embase、Ovid Medline、PubMed、Scopus和科学网核心合集。最终综述将以表格和附带的叙述性总结形式呈现批判性综合分析和结果。
本综述无需伦理批准。迄今为止,尚未采取系统方法对VLS症状进行分类,这有助于制定适用于小儿群体的疾病严重程度标准。我们相信,本综述的结果将有助于开发疾病严重程度量表,这在现实环境和临床试验中都有助于个体内和个体间的可比性。