目的探讨生殖器和生殖器外硬化性苔藓(LS)的临床病理特征,并比较两者的差异。方法回顾性分析北京医院皮肤科经病理检查确诊的55例生殖器及生殖器外LS患者的临床病理资料。结果55例患者中,男11例,女44例。其中,38,15和2名患者有生殖器病变,外皮病变,生殖器和外生殖器损伤,分别。再生前LS主要累及背部(14.55%)和四肢(7.27%)。在患者中,28.30%无症状,73.58%和24.53%感到瘙痒和疼痛,分别。无症状患者在外发病例中所占比例较高(χ2=31.224,P=0.000),生殖器LS患者的瘙痒症状明显高于生殖器外LS患者(χ2=39.073,P=0.000)。外阴疼痛仅出现在生殖器LS患者中。共检查55例患者的57个活检标本,其中40例来自生殖器病变,17例来自生殖器病变。除了乳头状真皮匀浆(100%),常见的病理变化包括角化过度(98.25%),萎缩(50.88%),基底细胞液化变性(52.63%),扩张血管(64.91%),血管周围淋巴细胞浸润(100%),组织细胞浸润(85.96%),和苔藓样炎性浸润(54.39%)。棘皮病比例较高(χ2=4.402,P=0.036),扩张血管(χ2=9.330,P=0.002),在生殖器LS病例中观察到嗜酸性粒细胞浸润(χ2=4.162,P=0.041)。在生殖器外LS病例中出现卵泡堵塞的比例较高(χ2=5.076,P=0.024)。结论已建立的生殖器LS和生殖器外LS在临床症状和病理变化方面表现出一定的差异,包括棘皮病,扩张的血管,嗜酸性粒细胞浸润,和卵泡堵塞。
Objective To investigate the clinicopathological characteristics of established genital and extragenital lichen sclerosus(LS)and compare the differences between them. Method The clinicopathological data of 55 patients with established genital and extragenital LS diagnosed by pathological examination in the Department of Dermatology of Beijing Hospital were retrospectively analyzed. Results The 55 patients included 11 males and 44 females.Among them,38,15,and 2 patients had genital lesions,extragenital lesions,and both genital and extragenital lesions,respectively.Extragenital LS mainly involved the back(14.55%)and extremities(7.27%).Among the patients,28.30% were asymptomatic,and 73.58% and 24.53% felt itchy and painful,respectively.The asymptomatic patients had a higher proportion in extragenital cases(χ2=31.224,P=0.000),and the itchy symptom was more common in genital LS cases than in extragenital LS cases(χ2=39.073,P=0.000).Vulvar pain only appeared in the patients with genital LS.A total of 57 biopsy specimens from the 55 patients were reviewed,of which 40 were from genital lesions and 17 were from extragenital lesions.In addition to papillary dermal homogenization (100%),the common pathological changes include hyperkeratosis(98.25%),atrophy(50.88%),basal cell liquefaction degeneration (52.63%),dilated blood vessels(64.91%),a perivascular lymphocytic infiltrate(100%),histiocytic infiltrate(85.96%),and lichenoid inflammatory infiltrate(54.39%).Higher proportions of acanthosis (χ2=4.402,P=0.036),dilated blood vessels (χ2=9.330,P=0.002),and eosinophilic infiltrate (χ2=4.162,P=0.041) were observed in genital LS cases.A higher proportion of follicular plugging appeared in extragenital LS cases (χ2=5.076,P=0.024). Conclusion The established genital LS and extragenital LS showed some differences in clinical symptoms and pathological changes including acanthosis,dilated blood vessels,eosinophilic infiltrate,and follicular plugging.