Preliminary Research Of The Effect Of Immunoglobulin And C3 In The Vulval White Lesion

Objective:Nonneoplastic epithelial disorders of vulva refers to the pigment alteration and degeneration of vulval skin and mucosa,which contains lichen sclerosus,squamous hyperplasia and other dermatosis.Lichen sclerosus and squamous hyperplasia are also called vulval white lesion,because the patientes' vulval skin and mucosa are almost white.The course of vulval white lesion is long, while the etiopathogenisis and pathogenesis are not definite.In recent years,the relationship between vulval white lesion and autoimmunity is becoming the focus. Considerable clinical investigations indicate that focused ultrasonic treatment is better than traditional means,whose therapeutic effect is favorable.However,its mechanism of action is not definite.Our prior studies have confirmed that the capital components of skin immune system,such as keratinocyte,langerhans cell and T lymph cell play important roles in the occurrence,development of the vulval white lesion and focused ultrasonic treatment.Immunoglobulin and C3,the main components of skin immune system,have multiple functions in local humoral immunity.However,there are not many reports about the pathogenesis of vulval white lesion.Our study,with immunohistochemistry,is to observe the expression of Ig and C3 in the patients' vulval skins,and analyze the relationship between the expression and the effect of focused ultrasonic treatment,which may provides new clues for the occurrence,development of the vulval white lesion and the mechanism of focused ultrasound.Methods:Ig and C3 were detected in three groups of vulval skin specimens by immunohistochemistry:32 vulval white lesion cases,of which 20 cases were squamous hyperplasia,12 cases were lichen sclerosus;10 normal cases;all patients were treated by focused-ultrasound,of which 12 cases were obtained specimens again.We observed the expression of IgG,IgM,IgA and C3,and contrasted the expression in different pathological types.By using the apparatus of CZF-1,with 10.0HZ,4.5W,we treated and ended the treatment when the impaired skins become hyperemic and hydropic.Respectively,follow-up was performed at 1,3,6months after treatment.We observed the symptoms and physical signs,compared them with the conditions before treatment,and analyzed the relationship between the Ig,C3 and the effect of focused ultrasonic treatment.Results:The deposition of Ig and C3 of patients is obviously more than that of normal cases.There is not Ig and C3 in normal skins.And the deposition after focused ultrasonic treatment is obviously decreaser than before.IgG and C3 have high expression in squamous hyperplasia,while IgA in vulval lichen sclerosus.Conclusion:Ig and C3 play important roles in the occurrence,development of the vulval white lesion.Focused ultrasound is effective through improving local immunity.