| Objective: In this research,the clinical characteristics of vulvar lichen sclerosus were analyzed and summarized by the first symptoms,skin lesion characteristics,waiting time for diagnosis,treatment method,course of treatment,prognosis,misdiagnosis rate,family history and whether other autoimmune-related diseases were combined with 108 clinically diagnosed childhood vulvar lichen sclerosus,which provided a basis for clinical diagnosis and treatment and improvement of prognosis.Methods: All the selected patients in this clinical follow-up survey study were from the dermatology clinic of our hospital from August 8,2010 to January 15,2021,and were clearly diagnosed as Childhood VLS by the associate chief physician and above experts combined with clinical and pathology,and the 108 girl patients were divided into two different groups,3-7 and 8-12 years old,and the clinical characteristics of the two groups of patients were based on the first symptoms,skin lesion characteristics,waiting time for diagnosis,treatment method,course of treatment,prognosis,misdiagnosis rate,statistical correlation was performed for clinical information such as family history and whether other autoimmune-related diseases were combined.Results: 1.There were 50 patients in the 3-7 year old group and 58 patients in the 8-12 year old group,and the average age was 7.6 years old in domestic and foreign studies on Childhood VLS.The mean age of patients in this study was 7.86±2.61 years.The study recorded an average duration of 7.5 months for VLS in girls,and 6±2 months for patients in this study,with an average waiting time of 10 months.2.In the 3-7 year old group,the proportion of skin lesions involving the labia majora,labia minora,anteriorjoint,posterior joint and perianal were 70%,14%,30%,76% and 60%,respectively,while the proportion of skin lesions involving these areas in the 8-12 year old group was 74%,24%,28%,67% and 34%,and there was no significant difference in data between the two different groups.3.92.6% of patients with uncomfortable symptoms such as itching chose to seek treatment,and only 7.4% of patients did not notice any uncomfortable symptoms.At the same time,data suggest that other sites of skin lesion involvement are not statistically significant.All patients have lesions such as hypopigmented patches or plaques.4.In this research,20 patients(18.5%)were associated with other autoimmune-related diseases,and the difference in data between the two different groups was not statistically significant in the comparison of immunerelated factors.5.In this research,25% of patients in this study missed or misdiagnosed at their first visit.6.50% of patients were treated with topical glucocorticoids,and the remaining 50% were treated with calcineurin inhibitors,except for one patient who stopped treatment by self-discontinuation,the skin lesions of the rest of the patients were relieved to varying degrees,and long-term consolidation therapy could reduce the recurrence rate of VLS.7.The average course of patients receiving topical hormone therapy was 6.29±3.10 months,while the average course of treatment with topical calcineurin inhibitors was 6.69±2.76 months,and the difference in data between the two different groups was not statistically significant.Conclusions: 1.Skin lesions in childhood VLS are most common with hypopigmented patches or plaques,which is most likely to involve the labia majora and posterior symphysis,and the most common subjective symptom is pruritus.There were no significant differences in the course of disease,skin lesion morphology,skin lesion involvement and accompanying symptoms between the 3-7 year old group and the 8-12 year old group.2.The misdiagnosis and missed rate of Childhood VLS reached 25%,and the average waiting time for treatment was 6±2 months.3.Childhood VLS is associated with autoimmune diseases,and 18.5% of girls have immediate family members with autoimmune-related diseases.4.The average course of topical glucocorticoid therapy and topical calcineurin inhibitor therapy was 6 months,and most patients had varying degrees of improvement in skin lesions,and the treatment effect of childhood VLS was obvious.Also long-term consolidation therapy could reduce the recurrence rate of VLS,and the average course of VLS in girls was 12±2.5 months... |
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