背景:缺乏研究羟氯喹治疗肛门生殖器硬化性苔藓或生殖器外硬化性苔藓的疗效。一个条件是,如果不及时治疗,可能导致更大程度的疤痕和恶性转化。
目的:本研究旨在分析人口统计学特征,临床病理特征,治疗反应,以及接受羟氯喹治疗的被诊断为肛门生殖器或生殖器外硬化性苔藓的患者的结局。
方法:对2018年至2023年在我院接受羟氯喹治疗的70例硬化苔藓患者进行了回顾性分析。
结果:在队列中,67例患者为女性,3个是男性。在23例患者中诊断出脊髓外硬化苔藓,16例表现出伴随的硬体重叠。瘙痒是主要的临床表现(67%)。显着比例的患者(36%)患有结缔组织疾病,提示羟氯喹治疗。在30例仅治疗硬化性苔藓的患者中,21个显示有反应,9个无反应。从对羟氯喹反应的更广泛比较来看,总体肛门生殖器反应率为84.6%,而生殖器外硬化性苔藓为50%.初始反应的中位时间为4个月。不利影响,主要是温和的,在10例(14.3%)患者中观察到。
结论:这项研究受到其回顾性性质和对单个中心数据的依赖的限制,导致样本量有限。
结论:羟氯喹具有良好的反应率和较低的不良反应发生率,因此有望作为肛门生殖器硬化性苔藓的治疗选择。然而,进一步调查,包括更大规模或前瞻性研究,必须确定其最终功效。
BACKGROUND: There is a dearth of studies investigating the efficacy of hydroxychloroquine in the treatment of either anogenital lichen sclerosus or extragenital lichen sclerosus, a condition that, if left untreated, could lead to a greater degree of scarring and malignant transformation.
OBJECTIVE: This study aims to analyze the demographic characteristics, clinicopathological features, treatment response, and outcomes of patients diagnosed with either anogenital or extragenital lichen sclerosus who received hydroxychloroquine therapy.
METHODS: A retrospective analysis was conducted involving 70 patients diagnosed with lichen sclerosus who underwent treatment with hydroxychloroquine at our institution between 2018 and 2023.
RESULTS: Among the cohort, 67 patients were female, and 3 were male. Extragenital lichen sclerosus was diagnosed in 23 patients, with 16 exhibiting concomitant morphea overlap. Itching was the predominant clinical presentation (67%). A notable proportion of patients (36%) had a connective tissue disorder, prompting hydroxychloroquine therapy. Among the 30 patients treated solely for lichen sclerosus, 21 demonstrated response and 9 had no response. From a broader comparison of response to hydroxychloroquine, the overall anogenital response rate was 84.6% as opposed to 50% in extragenital lichen sclerosus. The median time to initial response was 4 months. Adverse effects, predominantly mild, were observed in 10 (14.3%) patients.
CONCLUSIONS: This study is constrained by its retrospective nature and reliance on data from a single center, resulting in a limited sample size.
CONCLUSIONS: Hydroxychloroquine demonstrates promise as a therapeutic option for anogenital lichen sclerosus because of its favorable response rates and low incidence of adverse effects. However, further investigations, including larger-scale or prospective studies, are imperative to ascertain its definitive efficacy.