Abstract：
Vulvar lichen sclerosus (VLS) is a chronic, inflammatory disease which is accompanied by itching and pain, affecting the patient\'s daily life and sexual activity. However, the disease characteristics of children and adults are not completely the same. Currently, there are few studies in China that compare the characteristics of VLS between girls and adult female patients. The aim of this study was to compare the epidemiology, clinical features, and combined autoimmune diseases of VLS patients between girls and adult females, and to help clinicians better understand VLS in different age groups. We enrolled 744 female patients for analysis, divided by age into a child group (<18 years) and an adult group (≥18 years). Among girl patients, 94.6% had preadolescent onset, while among adult female patients, only 4.6% had preadolescent onset, which was a statistically significant difference. The highest percentage of adult female patients had onset during their child-bearing period (75.4%), while 20% had postmenopausal onset, with a significant difference when the three onset states were compared. White patches were equally common in both girl and adult female patients\' external genital area, while mossy lesions and labia minora atrophy were more common in adult female patients. Involvement of the clitoris, labia minora, and vaginal opening area were more common in adult patients. The perianal area was more commonly involved in girl patients. We found eight cases (1.2%) of secondary squamous cell carcinoma in adult female patients. We also found that 13 patients had concurrent lichen sclerosus lesions on the vulva and extragenital region, including two girls and 11 adult females. Extragenital lichen sclerosus (EGLS) occurred mostly in the torso. Clinicians should be aware of these differences so that early diagnosis and treatment of the disease can be achieved, to avoid irreversible anatomical alterations and the risk of cancer.
摘要：
外阴硬化性苔藓(VLS)是一种慢性,伴有瘙痒和疼痛的炎症性疾病，影响患者的日常生活和性活动。然而,儿童和成人的疾病特征不完全相同。目前,在中国，很少有研究比较女孩和成年女性患者的VLS特征。这项研究的目的是比较流行病学，临床特征,女孩和成年女性之间的VLS患者的联合自身免疫性疾病，并帮助临床医生更好地了解不同年龄段的VLS。我们招募了744名女性患者进行分析，按年龄分为儿童组（<18岁）和成人组（≥18岁）。在女孩患者中，94.6%有青春期前发病，而在成年女性患者中，只有4.6%的人在青春期前发病，这是统计学上的显著差异。成年女性患者在生育期间发病比例最高(75.4%)，而20%的人有绝经后发病，在比较三种发病状态时具有显着差异。白斑在女孩和成年女性患者的外生殖器区域同样常见，而苔藓病变和小阴唇萎缩在成年女性患者中更为常见。阴蒂的参与，小阴唇,阴道开放区域在成人患者中更为常见。肛周区域更常见于女孩患者。我们在成年女性患者中发现了8例（1.2％）继发性鳞状细胞癌。我们还发现13例患者在外阴和外阴区并发硬化性苔藓病变，包括两名女孩和11名成年女性。脊髓外硬化苔藓（EGLS）主要发生在躯干。临床医生应该意识到这些差异，以便对疾病进行早期诊断和治疗，以避免不可逆的解剖改变和癌症的风险。
