The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls
Abstract Introduction Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which can manifest in prepubertal or adolescent patients. The prevailing theories point to autoimmune and genetic factors. The primary symptoms of VLS typically include vulvar itc...
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2024-03-01
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| Series: | Dermatology and Therapy |
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| Online Access: | https://doi.org/10.1007/s13555-024-01124-0 |
| _version_ | 1827301309780328448 |
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| author | Agnieszka Dulska Jakub Bodziony Marta Janik Agnieszka Drosdzol-Cop |
| author_facet | Agnieszka Dulska Jakub Bodziony Marta Janik Agnieszka Drosdzol-Cop |
| author_sort | Agnieszka Dulska |
| collection | DOAJ |
| description | Abstract Introduction Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which can manifest in prepubertal or adolescent patients. The prevailing theories point to autoimmune and genetic factors. The primary symptoms of VLS typically include vulvar itching, discomfort, dysuria, and constipation. Physical examination often reveals a characteristic figure 8 pattern, involving the labia minora, clitoral hood, and perianal region. However, these symptoms and the age of onset are nonspecific and require differentiation from autoimmune dermatoses such as bullous diseases, pemphigus diseases, epidermolysis bullosa acquisita, and dermatitis herpetiformis. We performed this study to distinguish VLS from autoimmune dermatoses, and in doing so, uncover the underlying causes of chronic vulvar changes. This knowledge will enable healthcare providers to offer appropriate medical care to affected patients. Methods The study was conducted between July 2020 and February 2021, with a sample of 55 girls aged 2–18 years who did not have any systemic diseases. The study group was composed of 20 girls previously diagnosed with vulvar lichen sclerosus, while the control group included 35 girls without VLS. Questionnaires regarding the medical history of the children were completed by their legal guardians. Blood samples were collected and analyzed biochemically to assess human immunoglobulin A (IgA), IgG, and IgM antibodies against various substrates, including the desmosome of stratum spinosum, basement membrane zone, desmoglein 1 (DSG1), desmoglein 3 (DSG3), BP180-NC16A-4X, BP230gC, pemphigoid antigen, collagen type VII NC1, transitional epithelium, gliadin (GAF-3X), endomysium (EMA), and cellular nucleus (ANA). Results The analysis of the study group revealed that the most commonly observed signs and symptoms included: itching, soreness, burning sensations, and excoriation, as well as erythema or/and pallor of the skin and perineal mucosa. Among the assessed antibodies, only anti-GAF3x antibodies and ANA antibodies were detected. However, the results did not reach statistical significance (p > 0.5). |
| first_indexed | 2024-04-24T16:20:43Z |
| format | Article |
| id | doaj.art-24e47267d0b74d4db8f70163d4dd5d0c |
| institution | Directory Open Access Journal |
| issn | 2193-8210 2190-9172 |
| language | English |
| last_indexed | 2024-04-24T16:20:43Z |
| publishDate | 2024-03-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Dermatology and Therapy |
| spelling | doaj.art-24e47267d0b74d4db8f70163d4dd5d0c2024-03-31T11:11:03ZengAdis, Springer HealthcareDermatology and Therapy2193-82102190-91722024-03-0114375976610.1007/s13555-024-01124-0The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent GirlsAgnieszka Dulska0Jakub Bodziony1Marta Janik2Agnieszka Drosdzol-Cop3Chair and Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in KatowiceDepartment of Physiology, Faculty of Medical Sciences in KatowiceEuroimmun Polska Sp. Z O. OChair and Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in KatowiceAbstract Introduction Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which can manifest in prepubertal or adolescent patients. The prevailing theories point to autoimmune and genetic factors. The primary symptoms of VLS typically include vulvar itching, discomfort, dysuria, and constipation. Physical examination often reveals a characteristic figure 8 pattern, involving the labia minora, clitoral hood, and perianal region. However, these symptoms and the age of onset are nonspecific and require differentiation from autoimmune dermatoses such as bullous diseases, pemphigus diseases, epidermolysis bullosa acquisita, and dermatitis herpetiformis. We performed this study to distinguish VLS from autoimmune dermatoses, and in doing so, uncover the underlying causes of chronic vulvar changes. This knowledge will enable healthcare providers to offer appropriate medical care to affected patients. Methods The study was conducted between July 2020 and February 2021, with a sample of 55 girls aged 2–18 years who did not have any systemic diseases. The study group was composed of 20 girls previously diagnosed with vulvar lichen sclerosus, while the control group included 35 girls without VLS. Questionnaires regarding the medical history of the children were completed by their legal guardians. Blood samples were collected and analyzed biochemically to assess human immunoglobulin A (IgA), IgG, and IgM antibodies against various substrates, including the desmosome of stratum spinosum, basement membrane zone, desmoglein 1 (DSG1), desmoglein 3 (DSG3), BP180-NC16A-4X, BP230gC, pemphigoid antigen, collagen type VII NC1, transitional epithelium, gliadin (GAF-3X), endomysium (EMA), and cellular nucleus (ANA). Results The analysis of the study group revealed that the most commonly observed signs and symptoms included: itching, soreness, burning sensations, and excoriation, as well as erythema or/and pallor of the skin and perineal mucosa. Among the assessed antibodies, only anti-GAF3x antibodies and ANA antibodies were detected. However, the results did not reach statistical significance (p > 0.5).https://doi.org/10.1007/s13555-024-01124-0AdolescentVulvar lichen sclerosusAutoimmune dermatoses |
| spellingShingle | Agnieszka Dulska Jakub Bodziony Marta Janik Agnieszka Drosdzol-Cop The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls Dermatology and Therapy Adolescent Vulvar lichen sclerosus Autoimmune dermatoses |
| title | The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls |
| title_full | The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls |
| title_fullStr | The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls |
| title_full_unstemmed | The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls |
| title_short | The Need of Differential Diagnosis Between Vulvar Lichen Sclerosus and Autoimmune Dermatoses in Adolescent Girls |
| title_sort | need of differential diagnosis between vulvar lichen sclerosus and autoimmune dermatoses in adolescent girls |
| topic | Adolescent Vulvar lichen sclerosus Autoimmune dermatoses |
| url | https://doi.org/10.1007/s13555-024-01124-0 |
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