The Pathogeny And The Treatment Progress Of Vulvar White Lesions

Objective: This research mainly adopts the method ofimmunohistochemical to study the microvessel density of vulvar whitelesions, in order to explore the pathogenesis of vulvar white lesions.Bothsymptoms and typical signs were evaluated after the comprehensiveimmune therapy，repeated study micro vessel density and form,as toprovide theoretical basis for clinical treatment.Methods: from January2011to October2012in our hospital,collecting42patients confirmed for vulvar white lesions with pathologyexamination.22cases are squamous epithelial hyperplasia,19cases areLichen sclerosus of vulva,1case is squamous epithelial hyperplasiacombined lichen sclerosus. These cases are conducted the expression ofCD34in the diseased tissue through the methods ofimmunohistochemical.42patients treat with recombinant humanepidermal growth factor, recombinant human interferon gel, estriolointment, at1,3,6months,1year after the treatment according to theevaluation criteria determined curative effect, then take living tissuepathological examination and immunohistochemical study, comparebefore and after treatment in42cases of vulvar white lesion of CD34expression.8cases of normal vulvar tissues as control.Results:1.The micro vessel density (MVD) of vulval Lichen sclerosus was significantly lower than normal vulvar group (p<0.05), vulvarsquamous cell hyperplasia compared with normal vulvar tissue, there wasno statistically significant difference,there was a significant differencebetween Lichen sclerosus (LS) and squamous epithelial hyperplasiagroup (SH),the MVD value of Lichen sclerosus are lower thansquamous epithelial hyperplasia (p<0.05).2.Vulvar white lesion patientsafter drug treatment, clinical symptoms and signs were obviouslyimproved, the clinical effective rate was90%, The urticant,, scopechanges after treatment were statistically significant (p <0.05), especiallyitching has significant statistical significance before and aftercomparison(p<0.01), and through comparing the squamous cellhyperplasia with sclerosing moss found: there was no significantdifference in the improvement of itching,The flexibility improve ofsquamous epithelial hyperplasia and Lichen sclerosus have difference (p<0.05), squamous epithelial hyperplasia is better than sclerosing moss.3.The capillary number and morphology after treatment significantlyimproved (p<0.05).Conclusions:1. The microvascular abnormalities of vulva white lesions, lichensclerosus is the number of microvessels decreased, squamous epitheliumhyperplasia is microvascular function change, after treatment, the numberof microvessels and the function was better than before. It suggest that dermal vascular abnormalities, and secondary epidermal change, mybethe possible mechanism for white lesions of vulva.2. Application of recombinant human epidermal growth factor,recombinant human interferon gel, estrogen in the treatment of whitelesions of the vulva, provides a new way for the treatment. And vulvarsquamous cell hyperplasia treatment result is better thanlichen sclerosus,especially the lesion region of the elastic and color improvement.