女性外阴慢性单纯性苔藓的临床研究

【摘要】 目的 分析女性外阴慢性单纯性苔藓（VLSC）的临床特征。方法 回顾分析2017—2018年就诊于北京医院皮肤科外阴专病门诊的137例VLSC患者的临床特征。不符合正态分布的计量资料（年龄、病程）以M（P25，P75）表示，采用秩和检验比较，计数资料的比较采用χ2检验。结果 137例患者发病年龄32.0（25.5，40.0）岁，病程36.0（15.0，72.0）个月。32例（23.4%）有特应性疾病史，其VLSC发病年龄［29.5（25.0，35.8）］早于无特应性疾病患者［33.0（27.0，41.0），Z = 2.03，P = 0.042］。皮损特征方面，130例（94.9%）累及大阴唇，13例（9.5%）累及小阴唇，103例（75.2%）皮损双侧分布，8例（5.8%）出现色素减退。所有患者均有不同程度瘙痒，中度瘙痒44例（32.1%）、重度80例（58.4%），重度瘙痒患者占病程 > 2年患者的比例（68.1%）高于病程 < 2年的患者（47.7%），差异有统计学意义（χ2 = 5.83，P = 0.016）。患者自觉诱发瘙痒加重因素包括，局部潮湿出汗（55例，40.1%）、进食辛辣刺激食物（41例，29.9%）、精神紧张（36例，26.3%）。结论 VLSC好发于20 ~ 39岁，特应性体质可能是重要病因，主要累及大阴唇，多双侧分布，病程越长瘙痒越严重。

Clinical analysis of vulvar lichen simplex chronicus

Objective To investigate clinical features of vulvar lichen simplex chronicus(VLSC).Methods Clinical data were collected from 137 VLSC patients who visited a Vulvar Clinic in the Department of Dermatology,Beijing Hospital from 2017 to 2018,and analyzed retrospectively.Non-normally distributed measurement data(age and disease duration)were described as median(P25,P75),and analyzed by using rank sum test,and enumeration data were compared by using chi-square test.Results Among the 137 patients with VLSC,the age at onset was 32.0(25.5,40.0)years,and the disease duration was 36.0(15.0,72.0)months.Thirty-two(23.4%)patients had a history of atopic diseases,and the age at onset of VLSC was significantly lower in these patients with a history of atopic diseases(29.525.0,35.8]years)than in those without a history of atopic diseases(33.027.0,41.0]years,Z=2.03,P=0.042).The most frequently involved site was the labia majora(130/137,94.9%),and the labia minora was rarely involved(13/137,9.5%).Bilateral lesions were observed in 103(75.2%)patients,and hypopigmentation occurred in 8(5.8%)patients.All the patients experienced itching to different extents,including moderate itching in 44(32.1%)cases and severe itching in 80(58.4%).The ratio of patients with severe itching to those with disease duration>2 years(68.1%)was significantly higher than that of patients with severe itching to those with disease duration<2 years(47.7%,χ^2=5.830,P=0.016).Patients reported that local wetness and sweating(55 cases,40.1%),spicy diet(41 cases,29.9%)and mental stress(36 cases,26.3%)could aggravate itching.Conclusions VLSC commonly occurs in patients aged 20-39 years,and atopic predisposition may be an important factor for VLSC.VLSC mostly involves bilateral labia majora,and the longer the disease duration,the more severe the itching.