male genital lichen sclerosus

  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    男性生殖器硬化性苔藓(MGLSc)通常会影响外生殖器,导致龟头炎,勃起疼痛,排尿症状,和/或尿潴留。这些患者中有高达20%的患者出现尿道狭窄,通常在尿道的远端发现,但可以,在严重的情况下,影响整个尿道并引起结构变化。皮肤病变局限于包皮并部分延伸至龟头的患者通常可以通过包皮环切术治愈,但是当龟头或尿道广泛受累时,狭窄的复发率很高。在以下案例报告中,我们描述了一个45岁的男性,有3年的MGLSc病史和2年的尿道狭窄,这些情况在包皮环切术后仍未得到治疗。我们强调,5-氨基乙酰丙酸诱导的光动力疗法(ALA-PDT)治疗可进一步改善此类严重患者的预后。
    Male genital lichen sclerosus (MGLSc) typically impacts the external genitalia, resulting in balanitis, erectile pain, urination symptoms, and/or urinary retention. Urethral stricture develops in up to 20 % of these patients, which is usually found in the distal part of the urethra but can, in severe instances, impact the entire urethra and cause structural changes. Patients with skin lesions limited to the foreskin and partially extending to the glans can typically be cured by circumcision, but the recurrence rate of stricture is high when the glans or urethra is extensively involved. In the following case report, we describe a 45-year-old man with a history of MGLSc for 3 years and urethral stricture for 2 years, and these conditions remained untreated after circumcision. We emphasize that treatment with 5-aminolevulinic acid-induced photodynamic therapy (ALA-PDT) may further improve outcomes in such severe cases.
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  • 文章类型: Systematic Review
    我们评估了目前可用的保守治疗方法对阴茎和尿道硬化性苔藓的疗效和安全性。
    使用PubMed对现有关于硬化性苔藓的文献进行了系统的回顾,Embase,和WebofScience数据库。由3名独立审稿人通过标题和摘要评估了与男性生殖器硬化性苔藓非手术治疗的相关性。然后由5名独立审稿人进行完整和一式两份的审查。
    17项研究描述了男性患者经组织学证实的阴茎和尿道硬化性苔藓的保守治疗。我们提供了现有证据支持使用现有文献中代表的4种主要治疗方式:局部皮质类固醇,他克莫司,富血小板血浆,CO2激光我们还简要讨论了关于口服阿维A和多脱氧核糖核苷酸注射的有限研究。评估的结果包括症状,临床表现,生活质量,性满意度,不利影响,和长期疗效的治疗。
    外用皮质类固醇仍然是保守治疗阴茎和尿道硬化性苔藓的主要手段,目前的文献支持在需要升级治疗时使用他克莫司和富血小板血浆等其他疗法作为替代或辅助治疗。未来的研究应通过在目标人群中进行其他对照临床试验,进一步探索新疗法的有效性和安全性。
    UNASSIGNED: We evaluate the efficacy and safety profiles of currently available conservative management options for penile and urethral lichen sclerosus.
    UNASSIGNED: A systematic review of existing literature on lichen sclerosus was conducted utilizing the PubMed, Embase, and Web of Science databases. References were assessed for relevance to nonsurgical management of male genital lichen sclerosus by title and abstract by 3 independent reviewers, then reviewed in full and in duplicate by 5 independent reviewers.
    UNASSIGNED: Seventeen studies describing conservative management of histologically confirmed penile and urethral lichen sclerosus in male patients were included in the final review. We present available evidence supporting the use of 4 major treatment modalities represented in the existing literature: topical corticosteroids, tacrolimus, platelet-rich plasma, and CO2 laser. We also briefly discuss the limited studies on the use of oral acitretin and polydeoxyribonucleotide injections. Outcomes assessed include symptoms, clinical appearance, quality of life, sexual satisfaction, adverse effects, and long-term efficacy of treatment.
    UNASSIGNED: Topical corticosteroids remain the mainstay of conservative management of penile and urethral lichen sclerosus, with current literature supporting the use of other therapies such as tacrolimus and platelet-rich plasma as alternatives or adjuvant treatments when escalation of treatment is necessary. Future research should further explore the efficacy and safety of newer therapies through additional controlled clinical trials in the targeted population.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    男性生殖器硬化性苔藓(MGLSc)是一种慢性炎症性皮肤病,可导致男性性交困难和泌尿外科发病。一种古老的并发症是阴茎鳞状细胞癌(SCC)。MGLSc的确切病因仍存在争议,尽管遗传,自身免疫性和感染性(如人乳头瘤病毒(HPV)丙型肝炎(HCV),涉及爱泼斯坦-巴尔病毒(EBV)和疏螺旋体)因素:考虑所有证据表明,易感上皮长期暴露于包皮的尿路阻塞似乎是最可能的病理机制。治疗的主要方法是局部超效皮质类固醇治疗。手术适用于对局部皮质类固醇治疗无反应的病例。包茎,肉孔狭窄,尿道狭窄,原位癌(CIS)和鳞状细胞癌。
    Male genital lichen sclerosus (MGLSc) is a chronic inflammatory skin disease responsible for male sexual dyspareunia and urological morbidity. An afeared complication is squamous cell carcinoma (SCC) of the penis. The precise etiopathogenesis of MGLSc remains controversial although genetic, autoimmune and infective (such as human papillomavirus (HPV) hepatitis C (HCV), Epstein-Barr virus (EBV) and Borrelia) factors have been implicated: Consideration of all the evidence suggests that chronic exposure of susceptible epithelium to urinary occlusion by the foreskin seems the most likely pathomechanism. The mainstay of treatment is topical ultrapotent corticosteroid therapy. Surgery is indicated for cases unresponsive to topical corticosteroid therapy, phimosis, meatal stenosis, urethral stricture, carcinoma in situ (CIS) and squamous cell carcinoma.
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