目的:硬化外阴苔藓(VLS)是一种慢性炎症性皮肤病,主要影响妇女和儿童的肛门生殖器区域。迄今为止,专家们在援助评估的严重程度上缺乏一致意见,VLS的研究和治疗分层。此外,缺乏关于VLS长期管理最佳实践的文献。这一共识的目的是为VLS的短期和长期管理提供广泛的指导方针。
方法:澳大利亚外阴皮肤病学专家的初始焦点小组制定了VLS管理的共识声明草案。根据声明草案的结果,由22名澳大利亚专家组成的共识小组,由初始成员和额外成员组成,参与了一个匿名的四阶段eDelphi过程。第一轮涉及对焦点小组制定的共识声明草案中的声明进行生成和表决。在第2、3和4轮中,小组成员收到了前几轮的正式反馈,并要求他们表明他们的协议水平。如果对4(同意)至5(强烈同意)范围内的项目的重要性达成≥70%的共识,则达成共识。
结果:专家小组,在VLS领域总共有504年的集体经验,就与诊断相关的51份核心管理声明达成共识,严重程度,初始和长期管理,后续行动,和VLS的并发症。
结论:本研究确定了一套可用于澳大利亚人群临床实践的VLS管理声明。
OBJECTIVE: Vulval lichen sclerosus (VLS) is a chronic inflammatory skin condition predominantly affecting the anogenital region in women and children. To date, there is lack of agreement amongst experts on a severity scale to aid assessment, research and treatment stratification on VLS. Furthermore, literature on best practice for long-term management of VLS is lacking. The aim of this
consensus is to provide broad
guidelines on the short and long-term management of VLS.
METHODS: An initial focus group of Australasian experts in vulval dermatology developed a draft
consensus statement for the management of VLS. Based on the results of the draft statement, a
consensus panel of 22 Australasian experts, comprised of the initial and additional members, participated in an anonymous four-stage eDelphi process. Round 1 involved generation and voting on statements from the draft
consensus statement developed by the focus group. In Rounds 2, 3 & 4, panel members were presented formal feedback from previous rounds and asked to indicate their level of agreement.
Consensus was reached if there was ≥70% agreement on the importance of an item in the 4 (agree) to 5 (strongly agree) range.
RESULTS: The expert panel, with a total of 504 collective years of experience in the field of VLS, reached consensus on a core set of 51 management statements related to diagnosis, severity, initial and long-term management, follow-up, and complications of VLS.
CONCLUSIONS: This study has identified a set of management statements for VLS that may be useful in clinical practice in the Australasian population.