Initiatory Study Of The Effect Of Keratinocyte And Langerhans Cell In The White Lesions Of Vulva

Objective The white lesions of vulva is one of the skin diseases of women in vulva. It is a chronic skin disease characterized by vulva pruritus, skin achromasia, atrophy of vulva, narrow vaginal orifice and pain during coitus at the late stage. Because of the particular location, the treatment of the white lesions of vulva is one of the most troublesome problems in gynecology. For the past few years, it is considered that Immunization is one important factor of the cause of the white lesions of vulva. As the important immunologic cells of skin immune system, keratinocyte (KC) and langerhans cell (LC) act an important role in many skin diseases, such as psoriasis, oral leukoplakia and Behcet disease, etc. But the study of the roles of keratinocyte (KC) and langerhans cell in the white lesions of vulva is very little. Focus ultrasonic treatment for this disease is a kind of new noninvasive surgical therapy technique. This technique has good curative effect, but the curative mechanism of focus ultrasonic treatment is indefinite. We studied the amount of LC and the express of HLA-DR antigen in KC in the white lesions of vulva, and investigated the relationship of the express of HLA-DR antigen in KC and the therapeutic effect of focus ultrasonic treatment. The intention of the study is to investigate the affect of KC and LC in development, growth and treatment of the white lesions of vulva.Methods To take the vulvar skins of 30 patients of the white lesions of vulva (13 patients are of squamous cell hyperplasia,17 patients are of lichen sclerosus of vulva) \and the vulvar skins of 12 health adults. To detect the expression of S-100 and HLA-DR in the LC and the expression of HLA-DR in KC with immunohistochemical technique. To observe the the amount of LC expressing S-100 and HLA-DR and the express of HLA-DR antigen in KC. wetreated the 30 patients with focus ultrasonic therapeutic apparatus(CZF-1,Hifu). Therapy frequency was 10.40HZ and Power was 4.0W. The diseased regions were treated until obviously hyperemia and hydropsia appeared. Follow-up was performed at 1,3,6 months after treatment, respectively. Clinical symptoms and physical signs were observed and recorded to evaluate the therapeutic effect. To analyze the relationship of the express of HLA-DR antigen in KC and the therapeutic effect of focus ultrasonic treatment.Results The expression of S-100 and HLA-DR in the LC of patients is higher than that of health adults. The expression of HLA-DR~+ KC is detected in 18 patients and not detected in 12 health adults and 12 patients. Therapeutic effect of focus ultrasonic treatment of the patients with HLA-DR~+ KC (2cases were ineffective, 16 cases were effective)was better than the patients without HLA-DR~+ KC(6cases were ineffective,6cases were effective).Conclusion KC and LC act an import role in development, growth of the white lesions of vulva and therapeutic effect of focus ultrasonic treatment.