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Objective:To analyze changes in melanocyte density and epidermal thickness in vulvar lichen sclerosus (VLS) lesions.Methods:Vulvar skin tissues were collected from 15 adult female patients with VLS in Department of Dermatology, Beijing Hospital from June to December in 2018. According to pathological manifestations, 15 skin lesions were divided into early-stage VLS group ( n = 7) and late-stage VLS group ( n = 8) , and subjected to immunofluorescent staining. Then, density of melanocytes, and thickness of the whole epidermis and cell layers (from the bottom of the stratum corneum to the bottom of the basal layer) were calculated by using an image analysis software. Normal vulvar skin tissues were obtained from 15 healthy adult females after vulvar plastic surgery in Plastic Surgery Hospital, Chinese Academy of Medical Sciences, and served as control group. Results:The density of melanocytes in the epidermis was significantly lower in the early-stage VLS group (0.170 ± 0.071) and late-stage VLS group (0.110 ± 0.035) than in the control group (0.275 ± 0.036; F = 36.426, P < 0.001) . There was no significant difference in the thickness of the whole epidermis among the early-stage VLS group (203.682 ± 137.997 μm) , late-stage VLS group (150.020 ± 70.914 μm) and control group (194.030 ± 82.996 μm; F = 0.738, P = 0.487) . The thickness of cell layers did not differ between the early-stage VLS group (154.603 ± 121.984 μm) and control group (176.974 ± 80.296 μm; P = 0.899) , but was significantly thinner in the late-stage VLS group (83.455 ± 37.129 μm) than in the control group ( P = 0.003) . Conclusions:The density of epidermal melanocytes decreased in the early-stage and late-stage VLS skin lesions. Compared with the normal skin tissues, the early-stage VLS lesions showed no significant changes in the thickness of the whole epidermis and cell layers, but the late-stage VLS lesions showed decreased thickness of cell layers.
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Objective To analyze correlations of the distribution of non-segmental vitiligo lesions with gender,age of onset,duration of disease,personal and family history of autoimmune diseases,family history of vitiligo,and so on.Methods Clinical data were collected from 1 125 patients with confirmed nonsegmental vitiligo in Department of Dermatology,Beijing Hospital from January 2009 to January 2019,and analyzed retrospectively.Statistical analysis was carried out with SPSS 20.0 software by using independentsample t test and chi-square test.Results Of the 1 125 patients with non-segmental vitiligo,599 were males and 526 were females,with a male-to-female ratio of 1.14:1.Their age of onset was 27.9 ± 17.1 years,and duration of disease was 5.2 ± 8.0 years.Skin lesions mostly occurred on the trunk (544 cases,48.4％) and face (535 cases,47.6％),followed by acral regions (430 cases,38.2％),extremities (297 cases,26.4％) and neck (231 cases,20.5％).The perioral region (17.2％),hands (47.9％) and genital region (14.5％) in the 599 male patients were more frequently affected than those in the 526 females (9.7％,22.6％,6.3％,x2 =13.33,77.66,20.01,respectively,all P ＜ 0.001),while the neck (27.0％) was more frequently affected in the female patients than in the male patients (14.9％,x2 =25.29,P ＜ 0.001).The age of onset was significantly lower in the patients with vitiligo lesions involving the legs,knees,feet,trunk,genital and periocular regions than in those without skin lesions on the above corresponding body sites (all P ＜ 0.05),but significantly higher in the patients with vitiligo lesions involving the arms and hands than in those without lesions on the above 2 sites (both P ＜ 0.05).Vitiligo lesions more likely occurred on the hands of patients with a personal or family history of autoimmune thyroid diseases compared with those without the personal or family history (50.0％ vs.27.9％,x2 =6.62,P =0.010).The trunk was more frequently affected in the patients with a family history of vitiligo than in those without (59.6％ vs.45.7％,x2 =13.36,P ＜ 0.001).Conclusion The distribution of non-segmental vitiligo lesions are correlated to some extent with gender,age of onset,personal and family history of autoimmune diseases and family history of vitiligo.
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Objective To investigate clinical features of vulvar lichen simplex chronicus (VLSC).Methods Clinical data were collected from 137 VLSC patients who visited a Vulvar Clinic in the Department of Dermatology,Beijing Hospital from 2017 to 2018,and analyzed retrospectively.Non-normally distributed measurement data (age and disease duration) were described as median (P25,P75),and analyzed by using rank sum test,and enumeration data were compared by using chi-square test.Results Among the 137 patients with VLSC,the age at onset was 32.0 (25.5,40.0) years,and the disease duration was 36.0 (15.0,72.0) months.Thirty-two (23.4％) patients had a history of atopic diseases,and the age at onset of VLSC was significantly lower in these patients with a history of atopic diseases (29.5 [25.0,35.8]years) than in those without a history of atopic diseases (33.0 [27.0,41.0] years,Z =2.03,P =0.042).The most frequently involved site was the labia majora (130/137,94.9％),and the labia minora was rarely involved (13/137,9.5％).Bilateral lesions were observed in 103 (75.2％) patients,and hypopigmentation occurred in 8 (5.8％) patients.All the patients experienced itching to different extents,including moderate itching in 44 (32.1％) cases and severe itching in 80 (58.4％).The ratio of patients with severe itching to those with disease duration ＞ 2 years (68.1％) was significantly higher than that of patients with severe itching to those with disease duration ＜ 2 years (47.7％,x2 =5.830,P =0.016).Patients reported that local wetness and sweating (55 cases,40.1％),spicy diet (41 cases,29.9％) and mental stress (36 cases,26.3％) could aggravate itching,Conclusions VLSC commonly occurs in patients aged 20-39 years,and atopic predisposition may be an important factor for VLSC.VLSC mostly involves bilateral labia majora,and the longer the disease duration,the more severe the itching.
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Objective To analyze special histopathological characteristics of melanocytic nevi and their associations with age,gender,anatomical locations and pathological subtypes.Methods Clinical and histopathological data were collected from 1 011 patients with melanocytic nevi,who visited Beijing Hospital from January 2005 to January 2019,and analyzed retrospectively.Statistical analysis was carried out by using chi-square test for comparing enumeration data,and t test for comparing measurement data.Results Among the 1 011 patients with melanocytic nevi,the age at the clinic visit was 40.90 + 19.19years,and there were 289 males and 722 females.Lesional (biopsy) sites included the trunk (402 cases,39.8％),face and neck (268 cases,26.5％),extremities (138 cases,13.6％),hands and feet (133 cases,13.2％),scalp (53 cases,5.2％) and vulva (17 cases,1.7％).Pathological subtypes included intradermal nevus (580 cases,57.4％),compound nevus (333 cases,32.9％) and junctional nevus (98 cases,9.7％).Among special histopathological characteristics,neuralization and adipose cell hyperplasia were observed in 172 (17.0％) and 155 (15.3％) cases respectively,and the prevalence of neuralization and adipose cell hyperplasia was significantly higher in female patients than in male patients,higher in elderly patients than in young patients,and higher on the scalp than on the other sites (all P ＜ 0.05);vascular proliferation was observed in 313 (31.0％) cases,and more commonly occurred on the scalp than on the other sites (P＜0.05);nevus cells distributed along the hair follicles/sebaceous glands were observed in 502 (49.7％)cases,and more commonly seen on the face and neck than on the other sites (P ＜ 0.05);nevus cell lysis occurred in 203 (20.1％) cases,and fissures were observed in 384 (38.0％).All the above histopathological characteristics were more frequently observed in the intradermal nevus subtype than in the compound nevus subtype (all P＜0.05).Nevus cells distributed along the blood vessels were observed in 20 (2.0％) cases,and more commonly seen on the extremities than on the trunk,hands and feet (P ＜ 0.05),as well as in the compound nevus subtype than in the intradermal nevus subtype (P ＜ 0.05).Conclusions There are many special histopathological characteristics in melanocytic nevi,such as neuralization,adipose cell hyperplasia,vascular proliferation,and nevus cells distributed along the hair follicles/sebaceous glands,which are associated with patients' age,gender,lesional locations and histopathological subtypes.
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Objective To analyze the prevalence and characteristics of skin diseases in elderly patients with type 2 diabetes mellitus (T2DM).Methods Clinical out patient records for both elderly and non-elderly individuals with T2DM were collected from the dermatology department of Beijing Hospital.Statistical comparisons were performed between the elderly group and the non-elderly group on the prevalence of common skin complications and disease characteristics.Analysis was performed in the elderly group to identify any association of common skin disorders with gender,age,duration of T2DM,or level of glycosylated hemoglobin (HbA1c).Results Among 679 elderly T2DM cases,pruritus was the most common complication (26.1％),followed by eczema (21.t ％) and tinea pedis/onychomycosis (18.3％).Pruritus was more prevalent in the elderly group (177 cases,26.1％) compared to the non-elderly group (34 cases,9.8％) (x2 =6.006,P＜0.01).On the other hand,tinea pedis/onychomycosis was less prevalent in the senior group (124 cases,18.3 ％) than in the non-senior group (112 cases,32.2 ％) (x2 =37.437,P＜0.01).In the senior group,pruritus was more prevalent among male patients (105 out of 358 cases,29.3％) than among female patients(72 out of 321 cases,22.4％) (x2 =4.181,P =0.041).On average,patients with eczema were older[(72.3 ± 2.2)years] and had a longer history of T2DM [(8.3 ± 0.3)years] compared with patients without eczema[age:(65.2±1.9)years,history of T2DM:(5.2±0.1)years] (t=1.250,P=0.023 for age;t=1.680,P=0.033 for disease duration).Patients with tinea pedis/onychomycosis had higher HbA1c levels (6.7 ± 0.4) ％ than patients without tinea pedis/onychomycosis (6.1 ± 0.3) ％ (t =0.790,P＜0.01).Conclusions Pruritus is the most common skin complication in elderly patients with type 2 diabetes and is more common in elderly patients and male patients.Risk factors for developing eczema in elderly patients with type 2 diabetes may include older age and long disease duration.High levels of glycosylated hemoglobin in elderly patients with type 2 diabetes indicates increased risk for foot fungi infections.
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Objective To investigate clinical features and therapeutic protocols of vulvovaginal-gingival syndrome(VVGS). Methods Clinical data were collected from 11 female patients with VVGS and analyzed. Results Among the 11 patients, the mean and median ages at a definite diagnosis of VVGS were both 46 years, and the average disease duration was 4 years. Painful erosive erythema was found on the vaginal vestibule in 7 patients, on the gingiva in 10, as well as on the bilateral buccal mucosa in 5. Additionally, 8 and 4 patients reported dyspareunia and vaginal hemorrhage, respectively. Seven patients were treated with low-dose oral methylprednisolone combined with hydroxychloroquine or colchicine, and the other 4 were treated with oral hydroxychloroquine alone. Furthermore, all of the 11 patients applied topical tacrolimus 0.1%ointment. Finally, 8 patients were cured or markedly improved. No obvious adverse reactions were observed in any of the patients. Conclusions VVGS mostly occurs in middle-aged women, with the vaginal vestibule and gingiva as predilection sites of painful erythema and dyspareunia as common symptoms. Patients have good responses to methylprednisolone combined with hydroxychloroquine, and hydroxychloroquine alone also shows good efficacy in patients with mild VVGS. Tacrolimus 0.1%ointment can be one of drugs for topical maintenance treatment of VVGS.