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The article offers information on the 2018 guidelines for the management of lichen sclerosus published by the British Association of Dermatologists (BAD). The guidelines are prepared for the BAD Clinical Standards Unit and aims to provide up-to-date, evidence-based recommendations for the management of lichen sclerosus.

An atypical clinical form of pityriasis versicolor is reported, in which cutaneous atrophy was associated with the individual pityriasis versicolor lesions. The application of topical steroids probably plays a role in the development of the atrophy. [ABSTRACT FROM AUTHOR]

Summary: 硬化性苔癣(LS)是一种慢性皮肤病,多发于肛门和生殖器区域。本文章是一则指南,意思是,作者在科技期刊中查找了所有与LS有关的可用证据,并由此结合成针对成人(18岁以上)、儿童(0~12岁)和青少年(13~17岁)的疾病治疗的以证据为基础的最新建议。本指南由英国皮肤科医师协会的委员会撰写,遵循了评估关于本主题的所有不同研究所使用的严格标准。本指南有助于指导从事初级护理(意思是,患者出现健康问题的第一站,例如GP诊所、社区紧急处理中心)和二级护理(意思是,GP将患者送去以接受更专业护理的地方,例如医院)的医生和护士。本指南涵盖一系列问题,从治疗方案到需要解决的研究缺口。通过该指南,英国皮肤科医师协会网站( www.bad.org.uk)上创建并提供了更新的患者使用说明书。基于上述研究和专家共识,指南针对全科医师和二级护理专家提供了31条诊断和治疗LS的建议。此外,还以流程图的方式提供了适用于男性和女性的建议患者治疗方法。所有的证据都表明,有效的局部类固醇药膏是治疗此症状的最有效疗法。最初应涂抹药膏3个月,然后应根据各个患者的情况制定治疗应用的频率,以较好地控制症状和体征。指南还针对未来的研究提供了九条提议,以回答一些未解决问题,并填补了当前知识的空缺。 [ABSTRACT FROM AUTHOR]

Summary: Lichen sclerosus (LS) is a chronic skin disease mainly affecting the anal and genital region. This article is a guideline, which means that the authors looked at all the available evidence about LS in scientific journals, and from this, put together up‐to‐date, evidence‐based recommendations for the management of the disease in adults (18+ years), children (0–12 years) and young people (13–17 years). The guideline was written by a committee of the British Association of Dermatologists, following strict criteria they have for assessing all the different studies on the subject. The guideline helps to guide doctors and nurses working in primary care (which means a patient's first port of call when they have a health problem, e.g. GP clinics, walk‐in centres) as well as in secondary care (meaning where GPs will send people for more specialist care, e.g. hospitals). The guideline covers a range of issues, from treatment options, to gaps in research that need to be addressed. From the guideline, an updated Patient Information Leaflet has been created and is available on the British Association of Dermatologists’ website ( www.bad.org.uk). On the basis of these studies and expert consensus, 31 recommendations are made for the diagnosis and management of LS for both general practitioners and secondary care specialists. The recommended patient treatment pathways are presented as flow diagrams for men and women. All the evidence points to a potent topical steroid ointment as the most effective treatment for the condition. This is initially used for 3 months and then the frequency of treatment application is tailored to the individual patient to maintain good control of both symptoms and signs. Nine suggestions for future research studies are made to answer some outstanding questions and to fill gaps in current knowledge. [ABSTRACT FROM AUTHOR]

We present a patient with multiple leiomyomas confined to the left cheek, giving rise to an unusual clinical presentation of this condition. The lesions were cosmetically disfiguring and, because of their exposed location, were particularly painful in the winter months. The treatment of this condition is discussed. [ABSTRACT FROM AUTHOR]

A patient with sarcoidosis is described, in whom papular lesions confined to the vulva and peri-anal skin were the first manifestation of the disease. Vulval sarcoid is rare and has only been reported on one previous occasion. [ABSTRACT FROM AUTHOR]

The article presents the 2010 guideline from the British Association of Dermatologists (BAD), which aims to guide dermatologists on the management of lichen sclerosus skin disease among adults and children. It says that the content of the guideline was based from the 2002 edition and is supported by published randomized controlled trials. Furthermore, it adds that the guideline was written by dermatologists and can be revised if necessary changes in practice are required.

Involvement in pemphigus vulgaris of the female genital tract including the vulva, vagina and cervix has previously been described. In all these cases other cutaneous and mucosal sites have also been affected at some time. We describe a case of pemphigus vulgaris which only involved the vaginal mucosa. The patient presented with a persistent vaginal discharge and examination showed extensive vaginal erosions. Histology of vaginal biopsies was non-diagnostic. The recognition that the vaginal changes may represent an immunobullous disease led to further vaginal biopsies on which direct immunofluorescence studies were performed. These biopsies showed IgG and C3 in the intercellular epidermis, suggesting a diagnosis of pemphigus vulgaris. During the 3-year period that the patient has been under review there have never been any other cutaneous or mucosal lesions. To our knowledge, this is the first case of pemphigus vulgaris localized exclusively to the vaginal mucosa. There was considerable delay in diagnosis and this case highlights how important it is to recognize that chronic mucosal lesions at genital sites may be caused by immunobullous diseases such as cicatricial pemphigoid and pemphigus, and to institute appropriate investigations. [ABSTRACT FROM AUTHOR]