Финансирование. Исследование проведено без спонсорской поддержки. Financing. The study was performed without external funding.
Соответствие принципам этики. Исследование одобрено локальным этическим комитетом.Conformity with the principles of ethics. The study was approved by the local ethics committee.
Vulvar lichen sclerosus (LS) is a common chronic mucocutaneous disease, which is usually underdiagnosed and tend to progress without adequate treatment.Morphological characteristics of vulvar LS with unusual histological features.Vulvar biopsy material (n = 83) with morphologically diagnosed LS was examined histologically and statistically.Often saw-toothed modification of the epithelium, fibrinoid necrosis, cytoid bodies, satellite cell necrosis, hemorrhages, papillomatosis, milia, predominantly plasma cell inflammatory infiltrate, lymphoid follicles, elastosis, angiokeratoma-like vasculare change were found on the background vulvar LS.Saw-tooth epidermal change, multiple cytoid bodies and satellite cell necrosis are histological features of LS described for the first time in this study, the former being a frequent presentation of vulvar LS. The mentioned above histological changes cannot appear as features in favor of lichen planus in the differential diagnosis of these diseases.
Lichen sclerosus (LS) is a common chronic dermatosis predominantly involving external genital organs and having a malignant potential. The disease is usually clinically and morphologically underdiagnosed worldwide and in the Republic of Belarus in particular. To date LS gender morphological differences are still being examined.Aim: To establish gender morphological differences and the precancerous potential of male and female genital LS.Materials and Methods: Biopsy and surgical material of the foreskin and glans penis (n=61) and vulva (n=83) with a morphological diagnosis of LS was examined histologically and statistically. Two groups of patients were identified: 1 -Male genital LS, 2 -Female genital LS.
Results:The malignant potential of dermatosis was revealed to be higher in men (6.8%, n=4) than in women (2.4%, n=2). Penile intraepithelial neoplasia (PeIN) on the background LS occurred of both differentiated and undifferentiated types equally. Vulvar precancerous lesions in combination with LS were identified only in the form of high-grade squamous intraepithelial lesion (HSIL).A reliable association of PeIN with the early stage of the dermatosis was determined (p=0.00). In addition, a significantly more frequent association of the penile dermatosis with features increasing the risk of its malignant transformation, particularly squamous hyperplasia (SH) and basal atypia, as well as dyskeratosis and parakeratosis, was described.
Conclusions:The higher proportion of intraepithelial neoplasia and SH on the background of penile LS suggests that the malignant potential of this dermatosis is higher in men than in women.
Введение. Склероатрофический лихен (САЛ)-частый генитальный дерматоз, имеющий злокачественный потенциал. Иммуногистохимические предикторы малигнизации достаточно хорошо изучены в вульварном САЛ, в меньшей степени-в САЛ полового члена, без гендерного сравнения. Цель. Установить возможные гендерные различия в иммунофенотипе генитального САЛ с использованием белков р53, Ki-67, p16, CK17. Материал и методы. Исследована кожа и слизистая оболочка полового члена (n=40) и вульвы (n=57) с морфологически верифицированным САЛ. Проведена сравнительная гендерная ИГХ характеристика заболевания. Результаты. Впервые установлено, что иммунофенотип САЛ не имеет существенных гендерных различий и часто характеризуется гиперэкспрессией р53 (индекс маркировки >70), низким индексом маркировки Ki-67, без экспрессии p16 и CK17. Выводы. Вероятно, кожа и слизистая оболочка полового члена и вульвы при САЛ в равной степени могут подвергаться так называемому «ишемическому стрессу» с повышением р53 дикого типа.
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