دورية أكاديمية
Vulvar Lichenoid Dermatoses With Emphasis on the Distinction Between Lichen Sclerosus and Lichen Planus: A 10-Year Study.
العنوان: | Vulvar Lichenoid Dermatoses With Emphasis on the Distinction Between Lichen Sclerosus and Lichen Planus: A 10-Year Study. |
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المؤلفون: | D'Souza SL; Department of Pathology, St. John's Medical College, Bangalore, India., Ravikumar G; Department of Pathology, St. John's Medical College, Bangalore, India., Antony M; Department of Dermatology, St. John's Medical College and Hospital, Bangalore, India., Tirumale R; Department of Pathology, St. John's Medical College, Bangalore, India. |
المصدر: | Journal of lower genital tract disease [J Low Genit Tract Dis] 2024 Apr 01; Vol. 28 (2), pp. 189-197. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9704963 Publication Model: Print Cited Medium: Internet ISSN: 1526-0976 (Electronic) Linking ISSN: 10892591 NLM ISO Abbreviation: J Low Genit Tract Dis Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2002- : Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Malden, MA : Blackwell Science Inc., c1997- |
مواضيع طبية MeSH: | Lichen Sclerosus et Atrophicus*/pathology , Lichen Planus*/pathology , Vulvar Lichen Sclerosus*/diagnosis , Vulvar Lichen Sclerosus*/pathology, Female ; Humans ; Middle Aged ; Vulva/pathology ; Inflammation/pathology ; Biopsy |
مستخلص: | Objectives: Lichen planus (LP) and lichen sclerosus (LS) are the most common vulvar lichenoid dermatoses. The diagnostic challenges are due to site-specific variation in microscopic appearance and small-sized biopsies. Authentication of diagnostic criteria to distinguish LS and LP to uncover any resemblance or divergence in presentation of these conditions is attempted. Methods: Cases of vulvar LP and LS diagnosed between January 2012 to December 2022 were included. The clinical details included age, presenting symptoms, examination findings, and other organ involvement. Histopathological analysis of epidermal, dermal, and adnexal findings was done. Results: There were 28 cases of vulvar LP and 72 cases of LS, with a median age of 51 and 60 years, respectively. Depigmentation and atrophy were the major clinical features in LS, whereas ulcers/erosions and erythema were more prevalent in LP with a significantly higher incidence of oral involvement. The most diagnostic feature in LS was diffuse dermal sclerosis (76.8%) and interstitial pattern of inflammation (81.4%), whereas the characteristic features in LP cases was a lichenoid pattern of inflammation (85.7%), necrotic keratinocytes, and lymphocytic exocytosis. In 44.4% of LS, unconventional features like compact orthokeratosis, parakeratosis, thickened/wedge-shaped hypergranulosis, and sawtooth rete pegs were noted. Lichen sclerosus with lichenoid inflammation (21.4%) mimicked LP, from which it was distinguished by presence of thickened or diminished granular layer with basal melanin absence (60%) and dermal homogenization (80%). Conclusion: Although the classical, well-established variant of LS poses no diagnostic difficulty, the unconventional variant may mimic LP. Identification of the subtle histological clues demonstrated in this study can help to arrive at the correct diagnosis. Competing Interests: The authors have declared they have no conflicts of interest. (Copyright © 2024, ASCCP.) |
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تواريخ الأحداث: | Date Created: 20240322 Date Completed: 20240325 Latest Revision: 20240325 |
رمز التحديث: | 20240325 |
DOI: | 10.1097/LGT.0000000000000789 |
PMID: | 38518217 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1526-0976 |
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DOI: | 10.1097/LGT.0000000000000789 |