3,248 results on '"*LICHEN sclerosus et atrophicus"'
Search Results
202. Reflectance confocal microscopy features of chronic radiodermatitis: A useful tool for presurgical mapping.
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Rapparini, Luca, Venturi, Federico, Gelati, Chiara, Giorgini, Federico, Pignatti, Marco, Placa, Michelangelo La, Scotti, Biagio, Veronesi, Giulia, and Dika, Emi
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CONFOCAL microscopy ,RADIODERMATITIS ,BREAST ,REFLECTANCE ,MOHS surgery ,LICHEN sclerosus et atrophicus - Abstract
Reflectance confocal microscopy (RCM) is a useful tool for diagnosing skin cancers and inflammatory disorders. The article presents a case study of a 75-year-old woman with a history of breast cancer who developed an erythematous plaque in the right mammary area. RCM was used to map the lesion and revealed severe disruption of the corneal layer, areas of necrosis, and spongiosis. The diagnosis was post-radiation atypical vascular lesion, a rare complication of irradiated skin in breast cancer patients. Surgical excision is the recommended treatment, and further studies are needed to define RCM features of chronic radiodermatitis. [Extracted from the article]
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- 2024
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203. Correction: Nd:YAG/Er:YAG dual laser vs. topical steroid to treat vulvar lichen sclerosus: study protocol of a randomized controlled trial.
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Viereck, Volker, Gamper, Marianne, Regauer, Sigrid, Walser, Claudia, and Zivanovic, Irena
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LICHEN sclerosus et atrophicus ,RANDOMIZED controlled trials ,RESEARCH protocols ,LASERS - Abstract
The original article can be found online at https://doi.org/10.1007/s00404-023-07055-z.Correction: Archives of Gynecology and Obstetrics (2023) 308:643–649https://doi.org/10.1007/s00404-023-07055-zTable 1 of this article was mistakenly published with incorrect data. The correct Table 1 is provided below.The original article is also updated.GraphPublisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.By Volker Viereck; Marianne Gamper; Sigrid Regauer; Claudia Walser and Irena ZivanovicReported by Author; Author; Author; Author; Author [Extracted from the article]
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- 2024
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204. Reflectance confocal microscopy clinical applications: Hypopigmented skin lesions in pediatric patients.
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Wang, Ying, Chen, Lixin, Fang, Hongwei, and Li, Qinfeng
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CHILD patients ,LICHEN sclerosus et atrophicus ,REFLECTANCE ,CLINICAL medicine ,MACULES - Abstract
This article discusses the use of reflectance confocal microscopy (RCM) as a noninvasive imaging technique for diagnosing hypopigmented skin lesions in pediatric patients. The study included 52 children with various skin conditions, such as vitiligo, nevus depigmentosus, lichen striatus, and lichen sclerosus. RCM revealed specific diagnostic patterns for each condition, improving the accuracy of diagnosis. The article emphasizes the importance of RCM in identifying and managing hypopigmented skin diseases. [Extracted from the article]
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- 2024
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205. Case Report: Bullous Pemphigoid Associated With Morphea and Lichen Sclerosus: Coincidental Diseases or Pathogenetic Association?
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Maglie, Roberto, Baffa, Maria Efenesia, Montefusco, Francesca, Pipitò, Carlo, Senatore, Stefano, Capassoni, Marco, Maio, Vincenza, Cerinic, Marco Matucci, Antiga, Emiliano, and Guiducci, Serena
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LICHEN sclerosus et atrophicus ,BULLOUS pemphigoid ,SKIN diseases ,AUTOIMMUNE diseases ,AUTOANTIBODIES ,DISEASE remission - Abstract
Bullous pemphigoid (BP) represents the most common autoimmune bullous disease and is characterized by IgG autoantibodies targeting collagen XVII (BP180). BP has reportedly been occurred in association with other inflammatory skin diseases. Here, we describe the unusual occurrence of BP in a female patient with a concomitant history of generalized morphea (localized scleroderma, LoS) and cutaneous and genital lichen sclerosus (LiS). The occurrence of BP was associated with elevated serum levels of anti-BP180 IgG autoantibodies, which decreased upon clinical remission. Autoimmune bullous diseases and sclerosing dermatitis are immunologically distinct entities, whose association has been rarely described. In this study, we provide a literature review on cases of BP developed in patients with either LoS or LiS. Further, we discussed immunological mechanisms which may have favored the emergence of BP in our patient. [ABSTRACT FROM AUTHOR]
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- 2022
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206. Comparison of lichen sclerosus in boys and girls: A systematic literature review of epidemiology, symptoms, genetic background, risk factors, treatment, and prognosis.
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Kumar, Kajal S., Morrel, Beth, van Hees, Colette L. M., van der Toorn, Fred, van Dorp, Wendy, and Mendels, Elodie J.
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LICHEN sclerosus et atrophicus ,SCIENCE databases ,WEB databases ,SYMPTOMS - Abstract
Background: Studies concerning pediatric lichen sclerosus are limited, and, to date, there have been no studies comparing the course of lichen sclerosus in boys and girls. We sought to examine all publications on boys and girls with lichen sclerosus and assess and compare epidemiology, symptoms and signs, genetic background, risk factors, treatment, and prognosis. Methods: A systematic search was performed in the Embase, Medline, Cochrane, and Web of Science databases. Inclusion criteria were information on children ages 0–18 years and a clinical or histologic diagnosis of lichen sclerosus. Literature from 1985 to 2021 was reviewed. Results: A total of 1780 articles were retrieved from the search, of which 90 articles were eligible for inclusion. Boys and girls present similarly on many aspects; nonetheless, treatment and follow‐up are approached differently. Conclusions: Though the clinical approach is often different, lichen sclerosus in boys and girls demonstrates many similarities. More research is needed, especially on follow‐up, to gain a better understanding of the course of lichen sclerosus and establish an advanced management plan for children. [ABSTRACT FROM AUTHOR]
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- 2022
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207. Treatment of vulvar lichen sclerosus with a fractional CO2 laser -- case report.
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Stopińska, Kamila, Marzec, Adrianna, Olejek, Anita, and Niebudek, Tomasz
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THERAPEUTIC use of glucocorticoids ,LICHEN sclerosus et atrophicus ,VULVAR diseases ,LASER therapy ,CARBON dioxide ,ITCHING ,QUALITY of life ,DISEASE remission ,SYMPTOMS - Abstract
Vulvar lichen sclerosus (VLS) belongs to the group of autoimmune, chronic inflammatory skin disorders and is most frequent in females after their 50s. This disease might lead to vulvar scarring, sexual dysfunction and neoplasm transformation. For that reason, treatment of VLS is still considered an important clinical issue from the borderline of gynaecology and dermatology. Classical treatment includes the use of corticosteroids, which help to relieve symptoms, prevent further scarring of the vulva, reduce inflammation and reduce the risk of malignant transformation. Due to the resistance of some patients to local treatment and its complications, however, the use of fractional CO2 lasers in the treatment of VLS has been proposed. A 41-year-old female patient presented to a gynaecologist with symptoms such as itching, burning, and cracking of the vulva skin. A tissue sample was taken from the affected area and a histopathological examination confirmed the initial diagnosis. Treatment with topical glucocorticosteroids was applied, but no improvement was noticed. For that reason, a CO2 fractional laser was applied to the therapy with complementary treatment in the form of topical glucocorticosteroids. After 1.5 years, regression of lesions on the skin of the vulva was observed. This case report highlight the effectiveness of fractioned CO2 laser in the treatment of VLS resistant to glucocorticosteroid monotherapy. [ABSTRACT FROM AUTHOR]
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- 2022
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208. Autologous lipoaspirate as a new treatment of vulvar lichen sclerosus: A review on literature.
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van der Sluis, Nanouk, Scheers, Esther C.A.H., Krenning, Guido, van der Lei, Berend, Oonk, Maaike H.M., and van Dongen, Joris A.
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LICHEN sclerosus et atrophicus ,ITCHING ,ADIPOSE tissues ,SQUAMOUS cell carcinoma ,CHRONIC pain - Abstract
Lichen sclerosus (LS) is a chronic inflammatory dermatosis that mostly affects the genital and anal skin areas. Symptoms may vary from pruritis and pain to sexual dysfunction; however, LS can also be asymptomatic. LS occurs at all ages and in both sexes. Approximately 5% of all women affected by vulvar LS will develop vulvar squamous cell carcinoma. Topical treatment is safe but less effective resulting in chronic course in most patients, who suffer from persistent itching and pain. In severe cases of therapy‐resistant LS, there is no adequate treatment. Fat grafting is a novel regenerative therapy to reduce dermal fibrosis. The therapeutic effect of adipose tissue grafts for LS is already investigated in various pioneering studies. This review provides an overview of these studies and the putative mechanisms‐of‐action of fat grafting to treat LS. [ABSTRACT FROM AUTHOR]
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- 2022
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209. Platelet-rich plasma for genital lichen sclerosus: analysis and results of 94 patients. Are there gender-related differences in symptoms and therapeutic response to PRP?
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Tedesco, M., Garelli, V., Bellei, B., Sperduti, I., Chichierchia, G., Latini, A., Foddai, M.L, Bertozzi, E., Bonadies, A., Pallara, T., Romani, C., Morrone, A., and Migliano, E.
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PLATELET-rich plasma ,SEX factors in disease ,LICHEN sclerosus et atrophicus ,BURNING mouth syndrome ,AGE of onset ,SYMPTOMS - Abstract
Lichen sclerosus is a chronic relapsing inflammatory dermatosis with a predilection for anogenital skin in 85%–98% of cases and is more prevalent in women (3%) than in men (> 0.07%). The purpose of this study was to investigate gender differences in clinical presentation and therapeutic response to treatment with platelet-rich plasma (PRP), an emerging innovative strategy for LS. Forty-three male and 51 female patients affected by LS were evaluated. Each patient was subjected to PRP treatment (1 infiltration every 15 days, for 3 times). The PRP procedure was well tolerated by all patients and an overall significant decrease in symptoms was reported 6 months after PRP infiltration. Reduction in pain and burning sensation was significant in both gender but more accentuated in women than in men, whereas reduction of itching was similar. On the contrary, dyspareunia evidenced sex-related difference since a significant diminution was observed only in male. This study demonstrates that PRP based therapy may exert a relevant role in LS patient management due to its effect on Quality of Life (QoL) and sexual function in both gender. In addition, the study underlined gender-related differences in severity of symptoms and disease age onset. [ABSTRACT FROM AUTHOR]
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- 2022
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210. Complete Plaque Regression in Patients with Peyronie's Disease After Multimodal Treatment with Antioxidants: A Report of 2 Cases.
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Paulis, Gianni and De Giorgio, Giovanni
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PENIS curvatures ,PENILE induration ,COMBINED modality therapy ,CONSERVATIVE treatment ,THERAPEUTICS ,ULTRASONIC imaging ,LICHEN sclerosus et atrophicus - Abstract
Background: Peyronie's disease is a chronic inflammatory disease involving the tunica albuginea of the penile corpora cavernosa. Conservative medical treatment includes oral therapy, intralesional injections, and physical treatment. No cases of Peyronie's disease with complete plaque regression after conservative medical treatment are described in the literature. Case Reports: Case 1: A 50-year-old man presented with penile pain, combined penile curvature (left dorso-lateral), a palpable nodule, and normal penile rigidity. The patient underwent multimodal therapy with oral antioxidants, topical diclofenac gel, and periodic perilesional penile injections with pentoxifylline. At follow-up after over 3 years of multimodal treatment, the patient no longer had penile deformity or pain. Ultrasound imaging did not show any area affected by disease and plaque could no longer be observed. Case 2: A 55-year-old man presented with penile lichen sclerosus, dorsal penile curvature with onset about 6 months before, penile plaque, no penile pain, and normal penile rigidity. He underwent multimodal therapy with oral antioxidants, topical diclofenac gel, and periodic perilesional penile injections with pentoxifylline. At follow-up after over 3 years of multimodal treatment, he presented a dorsal curvature of the penis of about 5°, similar to his condition prior to the onset of congenital penile curvature. Ultrasound no longer showed plaque. Conclusions: This study showed that multimodal combined antioxidant treatment had satisfactory results. However, to accomplish this, we deem it essential to have a correct ultrasound assessment that is performed with a sufficiently advanced machine by an operator with extensive experience in the field. [ABSTRACT FROM AUTHOR]
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- 2022
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211. Biventricular cardiac metastasis from vulvar squamous cell carcinoma.
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Spînu, Ștefan, Sur, Daniel, Pârv, Andreea, Căinap, Călin, Stoia, Petruța, Creciun, Veronica, Bota, Mădălina, Pop, Alina, and Bochiș, Ovidiu
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VULVAR cancer ,SQUAMOUS cell carcinoma ,VENTRICULAR fibrillation ,LICHEN sclerosus et atrophicus ,ATRIAL fibrillation ,METASTASIS - Abstract
Vulvar cancers make up just 3% to 5% of all gynecological cancers, and they are most typically found in postmenopausal women. Vulvar cancer distant metastases are uncommon and usually arise late. Only six cases of vulvar cancer metastasizing to the heart have been reported in the literature, and none of them included both the left and right ventricles. We describe the case of a 68-year-old patient diagnosed with vulvar cancer arising from lichen sclerosus, initially localized, treated with chemotherapy, surgery, and radiation therapy. Less than two months after the end of the treatment sequence, the patient returned to our clinic with bone pain. Imaging investigations have shown multiple disseminated metastases, but not in the heart at that moment. Chemotherapy was initiated, and after two cycles, the patient developed an arrhythmia (atrial fibrillation with rapid ventricular rate), which was later determined to be caused by cardiac metastases discovered by echocardiography and computed tomography. Vulvar cancer metastatic to the heart represents a rare clinical condition, requiring multidisciplinary care. The case's uniqueness is the biventricular metastasis, which resulted in STEMI despite angiographically normal epicardial coronary arteries. [ABSTRACT FROM AUTHOR]
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- 2022
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212. The efficacy of injecting hybrid cooperative complexes of hyaluronic acid for the treatment of vulvar lichen sclerosus: A preliminary study.
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Tedesco, Marinella, Garelli, Valentina, Elia, Fulvia, Sperati, Francesca, Morrone, Aldo, and Migliano, Emilia
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LICHEN sclerosus et atrophicus ,HYALURONIC acid ,ITCHING ,SKIN diseases ,THERAPEUTIC complications ,TREATMENT effectiveness ,INTRA-articular injections - Abstract
Lichen Sclerosus is a chronic‐relapsing inflammatory skin disease usually involving the anogenital region lacking a resolutive therapy. Potent to high‐potent topical corticosteroids are considered to be the standard first‐line treatment. The objective of this preliminary study is to evaluate the efficacy of injecting Hybrid Cooperative Complexes of Hyaluronic Acid (HCC) in the treatment of Vulvar Lichen Sclerosus (VLS). Twenty‐female patients (range 21–78 years) with histopathologic diagnosis of lichen sclerosus and good general conditions were enrolled. Patients underwent HCC infiltration every month, for three times. Patients had been assessed at baseline (T0) and after 1 and 6 months from treatment (T1 and T2, respectively). Clinical evaluation was executed in every visit. Itching, burning sensation, pain and dyspareunia were reported by a patient at T0, T1, and at T2. The effectiveness of the treatment on patients' quality life and sexual life was assessed using the Dermatology Life Quality Index (DLQI) at T0 and at T2. During or after the treatment no complications or side‐effects were observed. All patients had a significant reduction in most symptoms after 1 and 6 months of HCC treatment. The reduction of patients with itching (p ≤ 0.001), pain (p = 0.031), burning sensation (p = 0.004) at 6 months is significant. The analysis of DLQI scores revealed a significant improvement in patients' quality of life. The DLQI mean score (±SD) at baseline and at follow‐up was 5.89 ± 3.68 and 3.42 ± 2.36 (p = 0.002), respectively. Our preliminary study has demonstrated the safety and tolerability of HCC infiltrations in patients with VLS, and the effectiveness of HCC in reducing symptoms and, thus, to improve patient Quality of Life. [ABSTRACT FROM AUTHOR]
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- 2022
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213. Transcriptional Activity of Some Genes Involved in Apoptosis in Patients with Vulvar Lichen Sclerosus.
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Klimov, E. A., Sobolev, V. V., Batashkov, N. A., Kokaeva, Z. G., Tretiakov, A. V., Nevozinskaya, Z. A., Korsunskaya, I. M., Sukhova, T. N., Evina, O. E., and Khashukoeva, A. Z.
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LICHEN sclerosus et atrophicus ,MYC oncogenes ,UTERINE fibroids ,GENES ,COMORBIDITY - Abstract
Lichen sclerosus of the vulva is a common, but poorly studied disease. We assessed the level of transcriptional activity of APAF1, BAX, BCL2, BIRC5, CCND1, DAPK1, MCL1, and MYC genes encoding products that control apoptosis in the samples of tissues affected by vulvar lichen sclerosus and adjacent control tissues (n=24). Analysis of transcriptional activity was performed by real-time PCR using specific primers and SYBR Green intercalating dye. After the total group was divided by the presence of the concomitant gynecological diseases, a significant increase in the transcriptional activity of the CCND1 gene was revealed in patients with concomitant uterine fibroids. This may indicate the possible role of the activation of mitosis during tumor initiation. [ABSTRACT FROM AUTHOR]
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- 2022
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214. The Effect of Vulvar Lichen Sclerosus on Urogynecological Functions in Postmenopausal Women.
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KARAKAŞ, Sema, YILDIZ, Şükrü, and YAŞAR, Levent
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LICHEN sclerosus et atrophicus ,BIOPSY ,VULVAR diseases ,GENITOURINARY organs ,CROSS-sectional method ,TERTIARY care ,MANN Whitney U Test ,COMPARATIVE studies ,POSTMENOPAUSE ,QUALITY of life ,QUESTIONNAIRES ,DATA analysis software ,WOMEN'S health - Abstract
Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
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215. Treatment Effect of Mometasone Furoate Cream on Lichen Sclerosus et Atrophicus of External Genitalia in Boys and Its Correlation with Toll-Like Receptor 4 and Myeloid Differentiation Factor 88.
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Sun, Hong, Zhang, Wei, Wang, Guibo, Sun, Chuanwei, Liang, Yan, Li, Aijun, Li, Qingfeng, and Lei, Jie
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LICHEN sclerosus et atrophicus ,MYELOID differentiation factor 88 ,TOLL-like receptors ,CHILD patients ,TREATMENT effectiveness ,GENITALIA - Abstract
Objective. The objective is to explore the treatment effect of mometasone furoate cream on lichen sclerosus et atrophicus (LSeA) of external genitalia in boys and its correlation with Toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88). Methods. A total of 100 boys treated in our hospital from January 2021 to January 2023 due to clinical manifestations in the external genitalia were selected as the study objects. All boys received redundant circumcision treatment, their protein expression of TLR4 and MyD88 in foreskin tissues was measured by BCA protein assay and western blot, and mometasone furoate cream was applied to those who were pathologically diagnosed with LSeA, so as to compare the levels of serum inflammatory factors and urodynamic indicators in the child patients before and after treatment. Results. The total clinical efficacy rate of LSeA child patients was up to 90.79%; after treatment, the maximum and mean urinary flow rates of child patients were significantly higher than before treatment P < 0.001 ; compared with the non-LSeA group, the protein expression of TLR4, MyD88, and NF-κB was increased in the LSeA group P < 0.001 , and the mRNA expression of TLR4, MyD88, and NF-κB was significantly increased in the LSeA group P < 0.001 ; the results of ROC curves showed that TLR4 had the highest AUC value, and during treatment, the incidence rate of adverse reactions in child patients was 6.58%. Conclusion. LSeA will increase the inflammatory reactions in child patients, and its pathogenesis may be related to the upregulation of TLR4, MyD88, NF-κB expression and thus activation of TLR4/MyD88/NF-κB signaling pathways. Applying mometasone furoate cream to LSeA patients after redundant circumcision can effectively reduce the inflammatory reactions in the body and improve their urodynamic indicators, with exact efficacy. Further research will be conducive to establishing a better treatment scheme for such child patients. [ABSTRACT FROM AUTHOR]
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- 2022
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216. Study on the application and imaging characteristics of optical coherence tomography in vulva lesions.
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Xu, Lida, Ma, Qian, Lin, Shaochong, Ju, Juan, Feng, Shuo, Shi, Zhongna, Bai, Yang, Song, Junzhai, Du, Junpeng, and Wang, Baojin
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VULVA ,OPTICAL images ,VULVAR diseases ,MEDICAL screening ,ADENOMATOUS polyps ,LICHEN sclerosus et atrophicus ,OPTICAL coherence tomography - Abstract
In this study, a prospective study was conducted by using optical coherence tomography (OCT) in the in vivo detection of vulvar diseases. The clinical efficacy of the OCT we investigated in the detection of vulvar diseases, and the characteristics of the OCT images were defined. Overall, this study recruited 63 patients undergoing the colposcopy for vulvar lesions in three Chinese hospitals from December 20th, 2018 and September 24th, 2019. The colposcopy and the OCT examination were performed successively, and the OCT images were compared with the relevant tissue sections to characterize different lesions. The OCT diagnoses where categorized into 7 types, including normal and inflammatory vulva, condyloma acuminata, papilloma, lichen sclerosus, atrophic sclerosing lichen, fibrous epithelial polyp as well as cysts. The structural characteristics of the vulva tissue can be clearly observed in the OCT image, which are consistent with the characteristics of the tissue section. Compared with the pathological results, the sensitivity, specificity and accuracy of the OCT examination reached 83.82% (95% confidence interval, CI 72.5%–91.3%), 57.89% (95% CI 34.0%–78.9%) and 78.16%, respectively. The OCT is found with the advantages of being noninvasive, real-time and sensitive and with high resolution. It is of high significance to screening vulva diseases, and it is expected as one of the methods to clinically diagnose vulva diseases. [ABSTRACT FROM AUTHOR]
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- 2022
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217. Extragenital Bullous Lichen Sclerosus Treated with Fractional CO2 Laser (FxCO2) and Wet Dressing of Halcinonide Solution: A Case Report.
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Yuan, Yunyan, Wang, Caroline J, and Li, Houmin
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LICHEN sclerosus et atrophicus ,LASERS ,SKIN diseases ,DISEASE relapse ,TREATMENT effectiveness ,BULLOUS pemphigoid - Abstract
Lichen sclerosis (LS) is an insidious, chronic, relapsing skin disease characterized by atrophic, porcelain-appearing plaques. It usually arises in the anogenital area, but some cases can present in extragenital regions with a variety of presentations, including a bullous variant. Topical corticosteroids are a first-line therapy and are usually the most effective treatment to induce remission of LS. However, there is a subset of patients that does not respond well to topical steroids. Herein, we report an extragenital bullous LS case successfully treated with a fractional CO
2 laser (FxCO2 ) and subsequent wet dressing of halcinonide solution. [ABSTRACT FROM AUTHOR]- Published
- 2022
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218. Extragenital lichen sclerosus: A retrospective study of 17 patients.
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Baklouti, Massara, Sellami, Khadija, Rekik, Mariem, Bahloul, Emna, Hammami, Fatma, Slim, Charfi, Masmoudi, Abderahmen, Sellami, Tahya, and Turki, Hamida
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LICHEN sclerosus et atrophicus ,RETROSPECTIVE studies ,SYMPTOMS - Abstract
Introduction: Lichen sclerosus is a chronic inflammatory and atrophic dermatosis affecting preferentially the anogenital region. However, the cutaneous involvement remains less known and studied. Methods: We collected 17 patients to study the clinical and therapeutic features of cutaneous lichen sclerosus. Results: We noticed that the frequency of extragenital involvement in our series is high (about 40%). There is a female predominance (76%), with two infantile cases presenting a severe involvement. On the other hand, the absence of sclerosis, in early forms, does not eliminate the diagnosis. Moreover, breast involvement was frequent (41%) and atypical locations, such as the face, were reported. There was an equal frequency between the diffuse and the localized forms. A genital involvement must imperatively be sought. Conclusions: Our series mention the frequency of isolated cutaneous lichen sclerosus. Clinical presentation can be misleading in the early forms because of lack of sclerosis, variability of localizations, variability of severity, and the absence of anogenital lichen sclerosus. [ABSTRACT FROM AUTHOR]
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- 2022
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219. An evaluation of prognostic factors, oncologic outcomes, and management for primary and recurrent squamous cell carcinoma of the vulva.
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Li, Jessie Y., Arkfeld, Christopher K., Tymon-Rosario, Joan, Webster, Emily, Schwartz, Peter, Damast, Shari, and Menderes, Gulden
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SQUAMOUS cell carcinoma ,PROGNOSIS ,VULVAR cancer ,VULVA ,LICHEN sclerosus et atrophicus ,MULTIVARIATE analysis - Abstract
Objective: To evaluate prognostic factors, outcomes, and management patterns of patients treated for squamous cell carcinoma of the vulva. Methods: One hundred sixty-four women were retrospectively identified with primary squamous cell carcinoma of the vulva treated at our institution between 1/1996-12/2018. Descriptive statistics were performed on patient, tumor, and treatment characteristics. The X2 tests and t-tests were used to compare categorical variables and continuous variables, respectively. Recurrence free survival (RFS), overall survival (OS), and disease-specific survival (DSS) were analyzed with Kaplan-Meier estimates, the log-rank test, and Cox proportional hazards. Results: Median follow-up was 52.5 months. Five-year RFS was 67.9%, 60.0%, 42.1%, and 20.0% for stage I-IV, respectively. Five-year DSS was 86.2%, 81.6%, 65.0%, and 42.9% for stage I-IV, respectively. On multivariate analysis, positive margins predicted overall RFS (hazard ratio [HR]=3.55; 95% confidence interval [CI]=1.18-10.73; p=0.025), while presence of lichen sclerosus on pathology (HR=2.78; 95% CI=1.30-5.91; p=0.008) predicted local RFS. OS was predicted by nodal involvement (HR=2.51; 95% CI=1.02-6.13; p=0.043) and positive margins (HR=5.19; 95% CI=2.03-13.26; p=0.001). Adjuvant radiotherapy significantly improved RFS (p=0.016) and DSS (p=0.012) in node-positive patients. Median survival after treatment of local, groin, and pelvic/distant recurrence was 52, 8, and 5 months, respectively. Conclusion: For primary treatment, more conservative surgical approaches can be considered with escalation of treatment in patients with concurrent precursor lesions, positive margins, and/or nodal involvement. Further studies are warranted to improve risk stratification in order to optimize treatment paradigms for vulvar cancer patients. [ABSTRACT FROM AUTHOR]
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- 2022
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220. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature.
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Kravvas, G., Ge, L., Ng, J., Shim, T. N., Doiron, P. R., Watchorn, R., Kentley, J., Panou, E., Dinneen, M., Freeman, A., Jameson, C., Haider, A., Francis, N., Minhas, S., Alnajjar, H., Muneer, A., and Bunker, C. B.
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TUMORS ,LICHEN sclerosus et atrophicus ,LITERATURE reviews ,SQUAMOUS cell carcinoma ,BOWEN'S disease ,PENILE cancer - Abstract
Penile intraepithelial neoplasia (PeIN) is a histological term for precancerous penile lesions. PeIN is important due to the high morbidity and mortality associated with progression to penile squamous cell carcinoma (PSSC). But PeIN is rare, contributing to a limited evidence-base for the relative efficacy of available treatment options. To consolidate and expand knowledge about PeIN and its treatment, we describe the clinical and histological characteristics, treatments and outcomes of 345 patients with PeIN, managed by our multidisciplinary team. Our results are compared and contrasted with those in the literature, following comprehensive review. 8.7% of patients had concomitant, invasive PSCC, whilst 91.3% demonstrated PeIN alone. 84% had undifferentiated PeIN, and 10.7% differentiated PeIN (5.2%, not specified). Clinical or histological evidence of HPV alone was present in 58%; features of lichen sclerosus alone in 12%; features of both in 29.4%. Only 14.4% of patients could be treated solely with topical agents or cryotherapy, whereas the remaining 85.6% underwent some form of surgical intervention, circumcision being the mainstay. Just 2.6% progressed to PSCC. Clinical management of PeIN can be rationally optimized with excellent outcomes. Circumcision is important. Topical treatments alone are disappointing. [ABSTRACT FROM AUTHOR]
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- 2022
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221. Fractional CO2 laser therapy of lichen sclerosus in males: a new therapeutic opportunity?
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Ferrara, Francesca, Messori, Stefano, Abbenante, Diego, Patrizi, Annalisa, and Bardazzi, Federico
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LASER therapy ,LICHEN sclerosus et atrophicus ,CARBON dioxide lasers ,LASER ablation ,DELAYED diagnosis - Abstract
Lichen sclerosus (LS) is a chronic relapsing disease with a predilection for the anogenital areas of patients of both sexes and at all ages. In males, LS is usually a late diagnosis, increasing the odds for serious complications up to the worse clinical scenario. LS is known to affect the quality of patients' social and interpersonal life. Here, we designed a study to monitor the possible beneficial effects of fractional photo-thermolysis with CO2 laser for treating penile LS during a non-active phase of the disease. Ten patients were enrolled in this study. They all underwent three ablation laser sessions, followed by a follow-up visit 6 months after the last treatment. In four out of five visits conducted, questionnaires were filled in by both clinician and patients to evaluate outcomes on quality of life (DLQI test), symptoms of LS (MenLas Observer Scale and MenLas Patient Scale), and sexual function (MSHQ questionnaire). Our study shows that treatment with fractioned laser CO
2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life. Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life. [ABSTRACT FROM AUTHOR]- Published
- 2022
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222. 口腔黏膜移植物尿道成形术治疗硬化性苔藓样变致长段 前尿道狭窄的临床分析.
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惠鹏宇, 张林琳, 倪锋, 郑亮, 牛彬, and 于靳
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URETHRA stricture ,LICHEN sclerosus et atrophicus ,LITHOTOMY ,URETHROPLASTY ,URETHRA ,URETHROGRAPHY - Abstract
Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2022
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223. Findings from University of Texas Southwestern Medical Center Yields New Findings on Lichen Sclerosus (Assessment of the Cutaneous Hormone Landscapes and Microbiomes In Vulvar Lichen Sclerosus).
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PROGESTERONE ,LICHEN sclerosus et atrophicus ,SEX hormones ,POSTMENOPAUSE ,NEWSPAPER editors - Abstract
A recent study conducted by researchers at the University of Texas Southwestern Medical Center explored the hormonal and microbial landscapes in postmenopausal females with vulvar lichen sclerosus (VLS), a progressive skin disease of unknown cause. The study found that patients with VLS had lower levels of groin cutaneous estrone and higher levels of cutaneous progesterone compared to controls. Treatment with topical steroids normalized the levels of estrone and progesterone, but testosterone remained suppressed. The study also revealed alterations in the bacterial and fungal microbiome in patients with VLS. These findings suggest that hormonal and microbial changes may be associated with VLS in postmenopausal females. [Extracted from the article]
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- 2024
224. Findings from Department of Pathology and Laboratory Medicine Has Provided New Data on Lichen Sclerosus (A Mimicker of Differentiated Vulvar Intraepithelial Neoplasia: Reactive Atypia From Noncompliance With Lichen Sclerosus Therapy).
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LICHEN sclerosus et atrophicus ,OLDER patients ,PATIENT compliance ,SQUAMOUS cell carcinoma ,CLINICAL pathology ,VULVAR cancer - Abstract
A study conducted by the Department of Pathology and Laboratory Medicine has found that lichen sclerosus (LS) can be mistaken for differentiated vulvar intraepithelial neoplasia (d-VIN), a precursor to vulvar squamous cell carcinoma. The researchers presented a case of LS in a 17-year-old female patient who had been using clobetasol 0.05% cream for 6 months without improvement. A biopsy revealed histologic findings typical of d-VIN, but further examination revealed noncompliance with treatment, leading to a misdiagnosis. The study emphasizes the importance of recognizing that untreated LS can mimic d-VIN and highlights the need for pathologists to be aware of this potential misdiagnosis. [Extracted from the article]
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- 2024
225. Researcher from Vrije Universiteit Brussel (VUB) Publishes Findings in Extramammary Paget's Disease (The Role of Line-Field Confocal Optical Coherence Tomography in Detecting Extramammary Paget Disease Recurrences: A Pilot Diagnostic Study).
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OPTICAL coherence tomography ,LICHEN sclerosus et atrophicus ,MEDICAL screening ,REPORTERS & reporting ,SKIN imaging - Abstract
A recent study conducted by researchers from Vrije Universiteit Brussel (VUB) explores the use of line-field confocal optical coherence tomography (LC-OCT) in detecting extramammary Paget's disease (EMPD) and its recurrence. EMPD is a rare adenocarcinoma that is often misidentified as benign skin conditions. Traditional diagnostic methods are invasive and uncomfortable, leading to the need for repeated biopsies. LC-OCT, a non-invasive imaging technique, shows promise in enhancing diagnostic accuracy and reducing unnecessary biopsies. The study found that LC-OCT had a high accuracy rate in detecting EMPD and its recurrence, but further research is needed to standardize its clinical application. [Extracted from the article]
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- 2024
226. Clobetasol/Isotretinoin/Prednisone: Lack of efficacy and hypertension : case report.
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LICHEN sclerosus et atrophicus ,TREATMENT effectiveness ,CLOBETASOL ,ISOTRETINOIN ,LIVER enzymes - Abstract
A 60-year-old woman experienced lack of efficacy and hypertension during treatment for lichen sclerosus et atrophicus (LSA). She initially received clobetasol and isotretinoin, but there was no improvement in her condition. She then received prednisone and methotrexate, but her prednisone treatment was discontinued due to hypertension and elevated liver enzymes. She was eventually treated with dupilumab, which resulted in significant therapeutic effects without adverse reactions. [Extracted from the article]
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- 2024
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227. Study Results from Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD) Update Understanding of Health and Medicine (Effect of Health Status and Heat-Induced Inactivation on the Proteomic Profile of Plasma Rich in...).
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DIGESTIVE system diseases ,MEDICAL research ,PROTEOMICS ,RESEARCH institutes ,LICHEN sclerosus et atrophicus - Abstract
A recent study conducted by the Biomedical Research Networking Center in Hepatic and Digestive Diseases (CIBEREHD) in Derio, Spain, explored the potential use of autologous-platelet-rich plasma (PRGF) in managing skin inflammation. The study analyzed the proteomic profile of PRGF obtained from donors with inflammatory skin conditions, such as psoriasis, lichen sclerosus, and atopic dermatitis. The researchers found differential abundance patterns of proteins related to key biological processes, including complement activation, blood coagulation, and glycolysis- and gluconeogenesis-related genes. Additionally, the study demonstrated that thermal treatment contributed to the inactivation of the complement system and reduced the immunogenic potential of PRGF products. This research provides valuable insights into the impact of health status and heat-induced inactivation on the proteomic profile of PRGF in patients with chronic inflammatory skin conditions. [Extracted from the article]
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- 2024
228. Peking Union Medical College Reports Findings in Vulvar Lichen Sclerosus (Vulvar lichen sclerosus in girls and adult females: A single-center retrospective study of 744 patients in China).
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LICHEN sclerosus et atrophicus ,VULVAR diseases ,VULVAR cancer ,ADULTS ,MEDICAL schools ,GENITOURINARY diseases ,MEDICAL sciences - Abstract
A recent study conducted in China compared the characteristics of vulvar lichen sclerosus (VLS) in girls and adult females. VLS is a chronic inflammatory disease that causes itching and pain, affecting daily life and sexual activity. The study found that the disease characteristics differ between children and adults, with the majority of girls experiencing preadolescent onset and adult females experiencing onset during their child-bearing period. The study also identified differences in the location and appearance of lesions between the two groups. It is important for clinicians to be aware of these differences in order to achieve early diagnosis and treatment and to prevent irreversible anatomical alterations and the risk of cancer. [Extracted from the article]
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- 2024
229. Dermatology Unit Researchers Publish New Studies and Findings in the Area of Lichen Sclerosus (Lichen sclerosus of the oral mucosa: a hidden phenomenon).
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LICHEN sclerosus et atrophicus ,ORAL mucosa ,RESEARCH personnel ,DERMATOLOGY ,MEDICAL screening - Abstract
A recent study conducted by researchers at the Dermatology Unit in Reggio Emilia, Italy, has shed light on the diagnostic challenges of oral lichen sclerosus (OLS). OLS is a rare condition characterized by whitish macules in the oral cavity. The study emphasizes the importance of accurate evaluation and multidisciplinary collaboration between dermatologists and oral disorder specialists for effective management. Although OLS is infrequent, it should be considered in the differential diagnosis of white macules in the oral cavity. Further research and awareness are needed to improve diagnosis and treatment of this condition. [Extracted from the article]
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- 2024
230. Findings from Erasmus University Medical Center Yields New Findings on Vulvar Lichen Sclerosus (Growing Up With Juvenile Vulvar Lichen Sclerosus: the Experiences and Care Needs of Adult Women With Lichen Sclerosus Since Childhood - a...).
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LICHEN sclerosus et atrophicus ,ACADEMIC medical centers ,ADULTS ,GENITOURINARY diseases ,MEDICAL personnel - Abstract
A recent study conducted by researchers at Erasmus University Medical Center in Rotterdam, Netherlands, explored the experiences and care needs of adult women who were diagnosed with vulvar lichen sclerosus (VLS) during childhood or adolescence. The study involved 27 in-depth interviews with women who had a confirmed history of juvenile VLS. The findings revealed three main themes: the varying impact of living with JVLS, the challenges of finding appropriate care and guidance, and the need for patient-tailored care involving compassionate and knowledgeable healthcare professionals. The study highlights the importance of age-appropriate and individually tailored care for women with VLS, as well as the need to improve awareness and knowledge about the condition among healthcare providers and the general public. [Extracted from the article]
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- 2024
231. First Affiliated Hospital of Soochow University Researchers Broaden Understanding of Lichen Sclerosus et Atrophicus (Efficacy of dupilumab in the treatment of severe vulvar pruritus associated with lichen sclerosus et atrophicus: a case report).
- Abstract
Researchers from the First Affiliated Hospital of Soochow University in Suzhou, China, have conducted a case study on the efficacy of dupilumab in treating severe vulvar pruritus associated with lichen sclerosus et atrophicus (LSA). LSA is a chronic inflammatory skin lesion with an unknown cause that primarily affects the genital area. The primary treatment for LSA involves the use of potent topical corticosteroids, but there are few reports on the use of dupilumab for this condition. In this case study, a 61-year-old woman with extensive vulvar itching experienced significant therapeutic effects, including vulvar skin thinning and relief from pruritus, after four months of dupilumab therapy. No adverse reactions were observed. Further research is needed to explore the potential of dupilumab as a treatment for LSA. [Extracted from the article]
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- 2024
232. Researchers at Ryhov County Hospital Target Lichen Sclerosus (Lichen Sclerosus-Incidence and Comorbidity: A Nationwide Swedish Register Study).
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LICHEN sclerosus et atrophicus ,RESEARCH personnel ,COMORBIDITY ,LICHENS ,HOSPITALS ,VULVAR cancer ,PENILE cancer - Abstract
A recent study conducted at Ryhov County Hospital in Sweden aimed to explore the incidence and comorbidity of Lichen sclerosus (LS), a skin condition, and its potential links to malignancies and autoimmune disorders. The study found that the incidence of LS in Sweden was 80.9 per 100,000 person per year, with higher incidence in females than in males. LS patients showed an increased odds ratio for various cancers and premalignant conditions, including vulvar cancer, penile cancer, prostate cancer, testicular cancer, bladder cancer, breast cancer, leukoplakia of the vulva, and leukoplakia of the penis. The study highlights the need for effective treatment and follow-up for LS patients, as well as further research to understand the underlying mechanisms and clinical management implications. [Extracted from the article]
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- 2024
233. Multiple drugs: Lack of efficacy and oesophagitis.
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DRUG efficacy ,ORAL medication ,SPINAL stenosis ,LICHEN sclerosus et atrophicus - Abstract
This article from Reactions Weekly describes two case studies of patients who experienced lack of efficacy and oesophagitis while being treated with various medications. The first patient, a 67-year-old woman, had vulvar lichen sclerosus (VLS) and received treatment with hydroxychloroquine, tacrolimus, triamcinolone, and ulobetasol, but experienced ongoing symptoms. She was later treated with methotrexate, which resulted in improvement. The second patient, a 35-year-old woman, also had VLS and received treatment with clobetasol and estradiol, but did not see any improvement. She developed oesophagitis while taking doxycycline for periorificial dermatitis, which led to complications but resolved once methotrexate was restarted. [Extracted from the article]
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- 2024
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234. A survey of adult men who underwent circumcision in childhood for pathological phimosis
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Harriet Jane Corbett, Kirsty Nweze, Ewoma Ukeleghe, and Caroline Sanders
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balanitis xerotica obliterans ,child ,circumcision ,lichen sclerosus et atrophicus ,surgical decision making ,Medicine (General) ,R5-920 - Abstract
Purpose: Pathological phimosis in childhood typically results in circumcision. Long-term follow-up data for men circumcised in childhood are lacking. This study sought long-term data regarding satisfaction with circumcision and voiding symptoms from men who had childhood circumcision between 1989 and 2010. Methods: Following ethical approval, a postal survey was sent to males > 17 years who underwent circumcision at an age < 16 years for pathological phimosis. Results: The survey was sent to 177 men, 23 completed surveys were returned [19 histology proven Lichen Sclerosus [LS, BXO], 4 chronic balanitis]. Mean age at circumcision was 9.7 years [range 3-15], at survey 23.5 years [18-37]. Seven [all > 9 years] remembered the decision for circumcision. Four warranted urologist review as adults, three required surgery for voiding symptoms and one still performs structure therapy; all had LS. When asked which treatment option[s] they would have considered; ten of them chose circumcision, nine of them chose preputioplasty, eight of them chose topical creams [two of them chose all three options, one man chose both foreskin preserving options]. Eight agreed with the statement “Having a circumcision in childhood or adolescence had an impact on my adult life”; this was positive in two men but negative in five men-they wouldn’t have chosen circumcision. Conclusions: The response rate to the survey was low, making it difficult to draw firm conclusions. However, even in this limited sample, not all men would choose childhood circumcision for pathological phimosis, data supporting the need for larger studies of alternative treatment options. In addition, some men circumcised for childhood LS had significant voiding difficulties in adulthood.
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- 2021
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235. Lichen sclerosus et atrophicus: atypical case simulating lichen planus
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Cadore Olinger, Rafaella, Lucius Jorizzo, Joseph, and Bochnia Cerci, Felipe
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lichen sclerosus et atrophicus ,lichen planus ,skin diseases - Abstract
Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis, characterized by shiny, atrophic, hypochromic papules with a predilection for the genital and perineal skin. Extragenital involvement may occur, but is rare in the isolated form. LSA more commonly affects prepubertal and postmenopausal women. We describe an unusual case of isolated extragenital LSA, restricted to the wrists and mimicking lichen planus.
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- 2017
236. Lichen sclerosus in female patients is associated with an increased risk of metabolic syndrome and cardiovascular comorbidities: a retrospective cohort review.
- Author
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Ranum, Alison, Freese, Rebecca, Ramesh, Vidhyalakshmi, and Pearson, David R.
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LICHEN sclerosus et atrophicus ,METABOLIC syndrome ,WOMEN patients ,DYSLIPIDEMIA ,TYPE 2 diabetes ,COMORBIDITY - Abstract
Lichen sclerosus in female patients is associated with an increased risk of metabolic syndrome and cardiovascular comorbidities: a retrospective cohort review Dear Editor, Lichen sclerosus (LS) is a chronic, inflammatory skin disorder that affects mucocutaneous surfaces, demonstrates a propensity for the genital area, and may profoundly impact patients' quality of life.[[1], [3]] The pathogenesis of LS has been linked to increased oxidative damage and has been associated with autoimmune disorders and genetic factors, although how these contribute to systemic inflammation is not wholly understood.[[4]] We postulate that behavioural changes and chronic inflammation in LS may lead to systemic manifestations, including dyslipidaemia and an increased risk of hypertension (HTN), type II diabetes mellitus (DM2) and cardiovascular disease, as in other inflammatory conditions like psoriasis.[[1], [6]] These and related conditions are grouped under metabolic syndrome (MS), which has a population prevalence of 20-30% and is more prevalent in women over the age of 50 years.[7] Cardiovascular comorbidities in LS have been briefly described in previous literature; in this study, we further evaluated the association between LS and MS.[5] Patients with LS were identified from outpatient dermatology or gynaecology clinics and were matched 1: 1 for age, sex and race/ethnicity with patients without a diagnosis of LS seen during the same period ("matched cohort"). We were unable to grade the severity of LS or associated comorbidities or assess the effect of LS-specific treatments on the risk of cardiovascular comorbidities. [Extracted from the article]
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- 2022
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237. Dermatoscopic features of pigmentary diseases in ethnic skin
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Keshavamurthy Vinay and Balachandra S Ankad
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dermatoscopy ,dermoscopy ,exogenous ochronosis ,lichen planus pigmentosus ,lichen sclerosus et atrophicus ,melasma ,pigmentary diseases ,vitiligo ,Dermatology ,RL1-803 - Abstract
Dermatoscopy is a non-invasive, handy tool, which is increasingly being used in diagnosis and prognostication of pigmentary dermatoses. Dermatoscopic changes in pigmentary pattern, scaling, and vasculature help us to differentiate among the myriad of hypo and hyper pigmentary diseases. This review gives a brief overview of the dermatoscopic features of pigmentary diseases, which are commonly encountered in clinical practice. We also provide a diagnostic approach based on salient dermatoscopic features.
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- 2021
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238. Biomarkers of Lichen Sclerosus
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Gynecologic Cancer Research Foundation, George Washington University, and Andrew T. Goldstein, MD, Study Investigator
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- 2018
239. Nd:Yttrium Aluminum Garnet Laser Treatment for Lichen Sclerosus
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Juna d.o.o. and Dr Adolf Lukanovič, Medical Director of the Division of Gynaecology
- Published
- 2018
240. MP06-12 GENOMIC CHARACTERISTICS OF LICHEN SCLEROSIS-INDUCED URETHRAL STRICTURES.
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Saltman, Anna J., Perecman, Aaron, Sullivan, Travis, Burks, Eric, Rieger-Christ, Kimberly, and Vanni, Alex
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GENE expression ,LICHENS ,CELL motility ,CELL communication ,LICHEN sclerosus et atrophicus ,URETHRA stricture - Published
- 2024
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241. Vulvar Lichen Sclerosus: Comparison Between Clobetasol Propionate, Photodynamic Therapy and Low-Intensity Laser (VLSCBCPPTLIL)
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Hospital Perola Byington and Daniela de Fátima Teixeira da Silva, Professor of Postgraduate program in Biophotonics applied to HealthSciences
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- 2017
242. What is the role of single-stage oral mucosa graft urethroplasty in the surgical management of lichen sclerosus-related stricture disease in men? A systematic review.
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Esperto, Francesco, Verla, Wesley, Ploumidis, Achilles, Barratt, Rachel, La Rocca, Roberto, Lumen, Nicolaas, Yuan, Yuhong, Campos-Juanatey, Felix, Greenwell, Tamsin, Martins, Francisco, Osman, Nadir, Riechardt, Silke, Waterloos, Marjan, and Dimitropoulos, Konstantinos
- Subjects
ORAL mucosa ,URETHROPLASTY ,URETHRA stricture ,LICHENS ,LICHEN sclerosus et atrophicus ,MEDLINE - Abstract
Purpose: The benefits and harms of the available types of surgical management for lichen sclerosus-related (LS) strictures remain unclear and, thus, clear and robust clinical practice recommendations cannot be given. Materials and methods: To assess the role of single-stage OMGU in the management of LS strictures and explore how its benefits and harms compare with the alternative management options. Medline, Embase and Cochrane controlled trial databases (CENTRAL, CDSR) were systematically searched. Randomized (RCTs) and nonrandomized studies (NRCSs) comparing single-stage OMGU with other surgical management options for LS strictures and single-arm studies on single-stage OMGU were included. Risk of bias (RoB) was assessed. Results: Of the 1912 abstracts identified, 15 studies (1 NRCS and 14 single-arm studies) were included, recruiting in total 649 patients. All studies were at high RoB. In the only NRCS available, stricture-free rate (SFR) for single-stage and staged OMGU was 88% vs 60%, respectively (p = 0.05), at a mean follow-up of 66.5 months. SFR range for single-stage OMGU in single-arm studies was 65–100% (mean/median follow-up, 12–59 months). Single-stage OMGU had low complication rates and beneficial impact on LUTS and QoL. Conclusions: The present SR highlights the methodological limitations of the available literature. In the absence of adverse local tissue conditions, and taking into consideration benefit–harm balance and surgeon's skills and expertise, single-stage OMGU can be justified in patients with LS strictures. [ABSTRACT FROM AUTHOR]
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- 2022
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243. Intralesional biologics for inflammatory dermatoses: A systematic review.
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Seivright, Justine R., Villa, Natalie M., De, Devea R., Hsiao, Jennifer L., and Shi, Vivian Y.
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BIOLOGICALS ,CROHN'S disease ,SKIN diseases ,PEMPHIGUS ,LICHEN sclerosus et atrophicus ,SARCOIDOSIS ,PYODERMA gangrenosum - Abstract
Biologic medications are systemic therapeutic options for inflammatory dermatoses. Local forms of administration are less well‐studied. To provide a summary of intralesional (IL) administration of biologics for various non‐malignant inflammatory dermatologic conditions reported in the literature. A systematic review was performed in the PubMed and Embase databases from 2000 to 2020. Inclusion criteria included the local use of biologic medications for non‐malignant cutaneous conditions. Quality was assessed with the modified Oxford Centre for Evidence‐Based Medicine ratings. A total of 19 articles describing the use of 5 biologic medications in 9 dermatologic conditions were identified, comprising 172 patients. Conditions successfully treated with intralesional biologics included pemphigus vulgaris (rituximab), granuloma faciale (rituximab), perianal Crohn's disease (infliximab), lichen sclerosus (adalimumab), and necrobiosis lipoidica (etanercept and infliximab). Intralesional etanercept reduced pruritus associated with keloids. A case report of the use of infliximab for pyoderma gangrenosum did not demonstrate any efficacy. There was no consistent effect noted with treatments for sarcoidosis (infliximab) or cutaneous lymphoid hyperplasia (rituximab). Local administration of biologic medications may offer an additional method of treating refractory inflammatory dermatoses, but further study is needed to develop standardized dosing protocols, clarify efficacy rates, and identify optimal treatment candidates. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
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244. Quality of life and sexuality in women with lichen sclerosus: a cross‐sectional study.
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Vittrup, G., Mørup, L., Heilesen, T., Jensen, D., Westmark, S., and Melgaard, D.
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LICHEN sclerosus et atrophicus ,QUALITY of life ,MEDICAL personnel ,CROSS-sectional method ,DYSPAREUNIA ,EVERYDAY life ,VULVODYNIA - Abstract
Summary: Background: Lichen sclerosus (LS) affects the female anogenital area, causing anatomical changes. Reported symptoms include itching, soreness and dyspareunia. Aim: To evaluate the quality of life and sexual functioning in women with LS. Methods: In total, 158 women aged over 18 years, diagnosed with LS, and referred to North Denmark Regional Hospital from January 2018 to November 2019, were included. Three questionnaires, the Female Sexual Function Index (FSFI), Dermatology Life Quality Index (DLQI) and the World Health Organization Five‐Item Well‐Being Index (WHO‐5), were completed. Results: The women (mean age 47 years, range 18–76) presented a low score on all FSFI scales, with a mean score of 13.83 (95% CI 12.46–15.20), indicating reduced sexual functioning. The subgroup evaluation scored for desire 2.32, arousal 2.23, lubrication 2.39, orgasm 2.28, satisfaction 3.02 and pain 1.59. The DLQI results revealed a mean score of 7.88 (95% CI 7.02–8.74), indicating a moderate effect on the women's everyday life. The mean subscores were treatment 0.32, sexual difficulties 1.56, relations 1.02, work/study 0.34, sport 0.45, social activities 0.54, clothing 0.89, shopping 0.22, embarrassment 0.99 and itching, soreness and pain 1.55. The mean score for the WHO‐5 was 56.66 (95% CI 53.48–59.84) indicating that 40% of the women had signs of depression. Conclusion: LS has a considerable influence on the sexual functioning and quality of life of women. Healthcare professionals must not only consider the biological aspects but also the psychological and social aspects. [ABSTRACT FROM AUTHOR]
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- 2022
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245. Lichen sclerosis–induced long segment anterior urethral stricture: The early outcome of one-stage repair using dorsolateral onlay buccal mucosa graft.
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Fathi, Atef, Mohamed, Omar, Mahmoud, Osama, Alsagheer, Gamal A, Reyad, Ahmed M, Hasan, Ahmed M, Abdelrazek, Mostafa, and Saber-Khalaf, Mohammed
- Subjects
URETHROPLASTY ,URETHRA stricture ,SURGICAL complications ,LICHEN sclerosus et atrophicus ,MUCOUS membranes - Abstract
Background: Substitution urethroplasty using buccal mucosal grafts can be performed by several approaches including ventral onlay graft, dorsal onlay graft, or ventral urethrotomy with dorsal inlay graft. Our study aims to evaluate the surgical outcome of dorsolateral buccal mucosal graft for long segment anterior urethral stricture >6 cm in patients with Lichen sclerosus (LS). Methods: A retrospective study included patients who underwent repair for long segment anterior urethral stricture >6 cm due to LS between January 2013 and April 2019. All patients were followed-up at 3, 6, 9, and 12 months postoperatively and then yearly by clinical symptoms, uroflowmetry, and calculation of post-void residual urine volume. Retrograde urethrogram was requested for patients with voiding symptoms or decreased maximum flow rate. Stricture recurrence that required subsequent urethrotomy or urethroplasty was considered failure. The success rate and surgical complications were collected and analyzed. Results: Thirty patients were identified. The median age (range) was 39 (25–61) years and a median (range) stricture length was 8 (6–14) cm. Most of postoperative complications were of minor degree. The success rate at median follow-up of 15 (12–24) months was 86.5%. The median maximum flow rate increased significantly from 6 (2–11) ml/s preoperatively to 18 (range: 6–23) ml/s at the 6th month (p value < 0.001). Conclusion: Dorsolateral buccal mucosal grafts urethroplasty for long anterior urethral stricture caused by LS has a high success rate and low risk of complications including stricture recurrence. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
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246. Proposition of standardized protocol for photodynamic therapy for vulvar lichen sclerosus.
- Author
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Declercq, Alicia, Güvenç, Canan, and De Haes, Petra
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LICHEN sclerosus et atrophicus ,PHOTODYNAMIC therapy ,VULVAR diseases ,LIGHT sources ,LIGHT intensity ,TREATMENT effectiveness - Abstract
Photodynamic therapy (PDT) is an alternative treatment modality for vulvar lichen sclerosus (VLS) which is a chronic inflammatory mucosal condition. In literature, no consensus of optimal parameters of PDT for VLS is reached so far. The aim of this narrative review is to develop a standardized treatment protocol for PDT in VLS. A systematic literature search was conducted to identify studies reporting on PDT in VLS and used treatment parameters, side-effects, and clinical outcomes were summarized. Thirteen studies used 5-aminolevulinic acid (5-ALA) with concentrations of 20%, 10%, 5% and three studies used methyl aminolevulinate (MAL). Generally, the light source was red light (median 630 nm). Light dose varied between 9 and 180 J/cm
2 and light intensity between 40 and 700 mW/cm2 . Incubation period with the photosensitizer ranged from 2 to 6 h. All studies showed a substantial improvement in VLS-related pruritus, burning and pain. Based on a literature review, we suggest the following protocol for PDT in VLS: 5% 5-ALA as a photosensitizer applied for 3 h under occlusion before irradiation at the dose of 120 J/cm2 with red light (590–760 nm) and intensity of 204 mW/cm2 . [ABSTRACT FROM AUTHOR]- Published
- 2022
- Full Text
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247. Lichen Sclerosus of the Male Genitalia -- The Current Level of Knowledge.
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Dick, A., Gingu, C., Baston, C., Ianiotescu, S., Andresanu, A., Dragan, C., Cairac, N., Himedan, O., Domnisor, L., and Sinescu, I.
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LICHEN sclerosus et atrophicus ,PENILE cancer ,MALE reproductive organs ,URETHRA stricture ,LYMPHADENECTOMY ,LITERATURE reviews ,PATIENT compliance - Abstract
Introduction and Objectives. Although discovered in the late 19th century by the American physician Robert F Weir, lichen sclerosus is still a condition not fully understood. Initially considered a simple skin disorder, it mainly affects the genital regions of both men and women, producing white hypomelanotic lesions, that if left untreated tend to evolve into more serious health related problems. In this paper we conducted a thorough review of the literature in order to assess the current level of knowledge of lichen sclerosus of the male genitalia, to identify its etiology, clinical presentation and diagnostic methods, and establish the main treatment options. Materials and Methods. So far a total of five etiologic factors have been considered for lichen sclerosus: autoimmunity, genetics, hormonal infiuence, repeated microtrauma and infections. As only empirical observations sustain each of them, and none alone can explain or predict lichen sclerosus, it is assumed that this condition has a multifactorial origin, and the precise appearance mechanism has yet to be determined. Regarding the lichen sclerosus of the male genitalia, four distinct clinical stages of presentation have been described, based on the extent of the disease and the complications it produces. During the first stage the white hypomelanotic lesions can be observed at the level of the prepuce, that gets scarred and brittle, and can lead to phimosis. For the second stage the lichen lesions also affect the glans of the penis, that can fuse with the phimotic prepuce. The third stage marks the involvement of the urethra, patients exhibiting stenoses and strictures, of various degrees of severity. And the fourth and most dangerous stage represents the malignant transformation of the involved tissues, resulting in squamous cell carcinoma of the penis or urethra, verrucous carcinoma of the penis, and erythroplasia of Queyrat. While definitive diagnosis is obtained after a histopathological examination of a removed specimen, the clinical presentation can often be enough to identify lichen sclerosus. Imaging like ultrasound, computed tomography or magnetic resonance is also required to correctly assess the extent of the complications. Results. Various treatment options have been employed for lichen sclerosus thus far, ranging from local ointments and creams to surgical excision and correction in the complicated cases. Some, like the revulsives and X-rays, retain only historic value, having been already abandoned. Out of the topical treatments used nowadays, meant to alleviate the symptoms and reduce the lichen affected areas, the most common are corticosteroids, calcineurin inhibitors, hormonal creams and retinoids. The same effects have been obtained with some forms of phototherapy. But when lichen sclerosus evolves beyond simple skin lesions, surgery is required in order to correct the acquired complications. If phimosis is associated, a complete circumcision of the involved tissue is needed. For the second stage, if the prepuce is fused to the glans, a restoration of lost obscured coronal sulcus procedure achieves the best results. In the third stage, when urethral strictures develop, various forms of urethroplasties are necessary to restore normal micturition, and even perineal urethrostomies are considered in cases of panurethral strictures. The fourth and most severe stage of lichen sclerosus, marked by the malignant transformation, imposes an oncologic treatment catered to the extent of the disease, from a simple excision of a prepuce or penile tumor, to complete emasculation and ilio-inguinal lymph node dissection, or even palliative chemotherapy in metastatic cases. Conclusions. Although known for almost 150 years, lichen sclerosus is still not a fully understood disease. Being considered a simple skin disorder for a long time, it's been overlooked by both patients and physicians, and its true incidence is underestimated. Only recently, after all the evolutive complications of lichen sclerosus have been identified, more effort has been invested in the diagnosis and treatment of this condition. While uncomplicated lichen sclerosus can be managed by topic therapies, advanced forms require complex surgical interventions and experienced physicians in order to achieve the best results. But further research is still needed to clarify the etiology and evolution risks. [ABSTRACT FROM AUTHOR]
- Published
- 2022
248. Does compliance to topical corticosteroid therapy reduce the risk of development of permanent vulvar structural abnormalities in pediatric vulvar lichen sclerosus? A retrospective cohort study.
- Author
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Kherlopian, Ashod and Fischer, Gayle
- Subjects
LICHEN sclerosus et atrophicus ,VULVAR diseases ,COHORT analysis ,HUMAN abnormalities ,CORTICOSTEROIDS ,AGE groups - Abstract
Background: Vulvar lichen sclerosus (VLS) is a chronic inflammatory dermatosis of the genital skin, with up to 20% of cases in the pediatric age group. Limited data exist concerning the prognosis of pediatric VLS, particularly the likelihood of permanent architectural change and whether this can be prevented by compliance with topical corticosteroid treatment (TCS). Objective: To evaluate the extent to which compliance to TCS treatment influences the risk of developing vulvar structural abnormalities, including clitoral phimosis and diminutive or fused labia minora. Methods: A retrospective chart review of case records of pediatric‐age females with VLS between January 31, 2004 and January 31, 2021. Results: One hundred eighteen cases of VLS were identified, with a mean age at diagnosis of 7.25 years and a mean follow‐up period of 42.7 months. Thirty‐four girls were "partially compliant," whereas 84 were "compliant." The risk ratio (RR) of developing any vulvar structural abnormality or clitoral phimosis was 5.76 (95% CI 2.96‐11.3) and 21.2 (95%CI 5.23‐85.9) times higher, respectively, in partially compliant compared with compliant subjects. The RR of a partially compliant female with pre‐pubertal onset VLS having a vulvar structural abnormality persisting beyond menarche was increased 3.54‐fold relative to compliant females (95% CI 1.75‐7.17). Limitations: The retrospective nature of our data, lack of a control group, wide variability in follow‐up duration, and nonstandardized method of stratifying compliance. Conclusion: Vulvar structural abnormalities are common in prepubertal onset VLS. Compliance to TCS appears to be critical in the prognosis of pediatric VLS although attitudes underpinning noncompliance to TCS treatment require further elucidation. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
249. STABILITY AND MICROBIOLOGICAL ANALYSIS OF ALOE BARBADENSIS AND CHAMOMILLA MATRICARIA PHARMACEUTICAL FORMS.
- Author
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Buzia, Olimpia Dumitriu, Madalina, Con, Tatu, Alin Laurentiu, Batir, Denisa Marin, Tiutiuca, Carmen, Ionuta, Grigore, Topor, Gabi, Focșăneanu, Sergiu, Iamandii, Mihaela, Schipor, Ovidiu, and Calin, Alina Mihaela
- Subjects
GERMAN chamomile ,DENTAL glass ionomer cements ,ALOE vera ,LICHEN sclerosus et atrophicus ,ALOE - Published
- 2022
250. High-intensity focused ultrasound therapy for pediatric and adolescent vulvar lichen sclerosus.
- Author
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Sili He and Jianfa Jiang
- Subjects
HIGH-intensity focused ultrasound ,LICHEN sclerosus et atrophicus ,PEDIATRIC therapy ,VULVAR cancer ,TEENAGERS - Abstract
Objective: The study’s objective was to retrospectively evaluate the efficacy and safety of high-intensity focused ultrasound (HIFU) for vulvar lichen sclerosus (VLS) in pediatric and adolescent patients. Methods: Pediatric and adolescent patients presenting to our hospital from June 2007 to July 2021, with VLS were retrospectively evaluated. The participants’ information, including age, symptoms and vulvar examination, were documented, and they were treated with HIFU. The effectiveness of HIFU and its complications were analyzed. Results: A total of 36 patients with VLS undergoing HIFU for whom complete follow-up data were available participated in the study. The mean age of the patients at diagnosis was 13.3 ± 4.1 years. All patients successfully underwent HIFU therapy. The mean sonication time was 20.3 ± 8.6 min, and the median treatment energy was 3579.0 J. A few blisters developed in 8 (22.2%) patients and 2 (5.6%) had ulcers. The skin burns were treated medically without scar formation. On average, patients were followed up for 52.0 months after the procedure (a range of 6–175 months). At 6 months after therapy, the total response rate was 91.6%, and 86.6% at 12 months post HIFU. Overall, 16 patients were followed up for more than 5 years. The total response rate was 75%, and the recurrence rate was 12.5%. Conclusions: Based on our results, HIFU was demonstrated to be effective and relatively safe for the treatment of VLS in pediatric and adolescent patients, but it is necessary to pay attention to the possible skin burns. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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