Clinical features and reflectance confocal microscopy characteristics of vulvar lichen sclerosus
10.3760/cma.j.cn431274-20190802-00910
- VernacularTitle:女阴硬化性苔藓的临床及反射式共聚焦显微镜图像特征分析
- Author:
Wenjing CHEN
1
;
Shirong YU
;
Caoying WU
;
Dezhi ZHANG
;
Jianyong LIU
;
Xiaojing KANG
Author Information
1. 新疆维吾尔自治区人民医院皮肤性病科，新疆皮肤病研究重点实验室，乌鲁木齐 830001
- From:
Journal of Chinese Physician
2020;22(11):1686-1689
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features and reflectance confocal microscopy (RCM) characteristics of vulvar lichen sclerosus (VLS).Methods:RCM examination was carried out in 34 patients who were preliminarily diagnosed as VLS in People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to June 2019, the results of the various indicators were recorded, and then a histopathological examination was performed at the same site.The RCM image characteristics were analyzed against histopathological manifestations, after that the results were compared and calculated the consistency rate of these image features.Results:The RCM image features of 28 patients with VLS were as follows: the thickness of spinous layer of lesion was thinner than that of surrounding normal skin (epidermis atrophy) in 21 cases (75%); hyper reflectance in basal layer was decreased in 21 cases (75%); In 16 (57.14%)cases, the basal cell ring was absent at the junction of the epidermis, the boundary was blurred, and the infiltration of mononuclear cells and scattered round like large cells in the superficial dermis (liquefaction and degeneration of basal cells); 28 cases (100%) had increased refractive index of superficial dermis (collagen homogenization). The coincidence rates with histopathological examination were 89.29%, 92.86%, 85.71% and 100%, respectively. The sensitivity and specificity of the increase of refractive index in the superficial dermis were the highest, reaching 96.53% and 62.35%. The highest specificity was 92.82% in the presence of epidermal atrophy and the increase of refractive index of superficial dermis.Conclusions:The RCM images of VLS were highly consistent with the histopathological examination.It also has high sensitivity and specificity.Combined with clinical manifestations, it can provide effective help for the diagnosis of vulvar lichen sclerosus and the judgment of therapeutic efficacy.
