中国麻风皮肤病杂志 ›› 2022, Vol. 38 ›› Issue (7): 442-446.doi: 10.12144/zgmfskin202207442

• 论著 • 上一篇    下一篇

硬化性苔藓64例临床及病理学特征分析

李昕雨,吕亚婷,郭淑兰,王玉坤,于晓静   

  1. 山东大学齐鲁医院皮肤科，济南，250012
  • 出版日期:2022-07-15 发布日期:2022-05-17

Clinical and pathological characteristics of 64 cases with lichen sclerosus

LI Xinyu, LYU Yating, GUO Shulan, WANG Yukun, YU Xiaojing   

  1. Department of Dermatology，Qilu Hospital of Shandong University, Jinan 250012, China
  • Online:2022-07-15 Published:2022-05-17

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摘要： 回顾性分析我院皮肤科2016年1月1日至2020年6月30日经组织病理学确诊的64例硬化性苔藓（LS）患者的临床及病理资料，平均年龄(36.84±17.84)岁；男女比例1∶2.5。外阴组患者25例（39%），非外阴组39例（61%），两组性别、年龄差异无统计学意义。非外阴组患者临床误诊率（38.5%）高于外阴组（12%），差异有统计学意义（P=0.022）；外阴组患者比非外阴组患者更易出现瘙痒，组织病理学中更容易出现表皮增生、嗜酸粒细胞浸润及毛细血管扩张，两组比较差异有统计学意义（P值分别为0.048、＜0.001、0.021及0.035）。9例患者行皮肤镜检查，镜下均见黄白色无结构区及毛细血管扩张，6例见毛囊角栓，7例见亮白色条束。本研究显示非外阴部位的LS并不少见，且更容易出现误诊，皮肤镜检查具有一定辅助诊断作用。

关键词: 硬化性苔藓, 临床, 组织病理, 皮肤镜

Abstract: The clinical and pathological data of 64 patients with lichen sclerosus (LS) diagnosed by histopathology in the Department of Dermatology in our hospital from January 1, 2016 to June 30, 2020. The average age of the patients was 36.84±17.84 years and the male to female ratio was 1∶2.5. The lesions were located on the vulva in 25 cases (39%) (vulva group) and on other body parts in 39 cases (61%) (non-vulva group)，there was no significant difference in gender and age between the two groups. The clinical misdiagnosis rate of non-vulva group (38.5%) was higher than that of vulva group (12%), with a significant difference (P=0.022). The patients in vulva group was more prone to pruritus, epidermal hyperplasia, telangiectasis and eosinophil infiltration than  in the non-vulva group, with a significant difference (P<0.05). Nine patients underwent dermoscopy, and white-yellowish structureless areas and telangiectasis were seen in 9 cases, follicular plugs in 6 cases and white shiny lines in 7 cases. The study showed the LS lesions located on non-vulvar  is not uncommon and and it is more likely to be misdiagnosed. Dermoscopy plays an auxiliary role in diagnosis.

Key words: lichen sclerosus, clinical, histopathology, dermoscopy