湖南地区124例扁平苔藓的临床分析

Lichen planus in Hunan:124 patients

目的:探讨湖南地区124例扁平苔藓患者的临床特点,为其诊断和治疗提供参考。方法:对2000年1月至2008年4月在中南大学湘雅医院皮肤科就诊的湖南地区124例扁平苔藓患者的性别、年龄、病程、临床表现和组织病理等方面进行回顾性分析。结果:扁平苔藓患者无性别差异(男∶女为1∶1),可发生于任何年龄,就诊年龄分布以30～60岁为高峰,而发病年龄则呈现出14～29岁,40～60岁2个高峰。皮损以慢性局限性最为多见,占35.5%。四肢为好发部位,且59.7%首发于四肢;其次为躯干29例,占23.4%。15例(12.1%)累及外生殖器,9例(7.3%)伴发口腔损害。皮损以单侧分布居多,占44.3%。64例(51.6%)伴有不同程度瘙痒,56例(45.2%)无自觉症状,4例(3.2%)自觉疼痛或压痛。2例(1.6%)患者伴有家族史。临床和病理阳性诊断符合率为50.8%。结论:湖南地区扁平苔藓患者在性别、病程、临床表现上具有其分布特点。治疗上,应针对扁平苔藓的皮损特点、部位及临床类型采用全身治疗和(或)局部治疗,并对反复发作者进行随访观察。

Objective To determine the clinical feature of lichen planus in Hunan,and to provide references for correct diagnosis and treatment. Methods The clinical data from 124 outpatients with lichen planus attending Dermatology Department of Xiangya Hospital,Central South University from January 2000 to April 2008 were analysed retrospectively,including data on sex,age of visit or onset,course of disease,clinical manifestation,histopathology,and so on. Results In these 124 patients,male to female ratio was 1 ∶ 1. Most patients were in 30 - 60 age group when they first visited the Out-patient Department. There were 2 onset peaks,one in 14 - 29 age group and the other in 40 - 60 age group. Most （ 35. 5% ） of the lesions were chronic localized subtypes. The limbs were the most common site to be involved,and they were also the most prevalent site for onset of lichen planus（ 74 cases,59. 7% ） . The second common site was the trunk （ 29 cases, 23. 4% ） . Fifteen patients （ 12. 1% ） had genitalia lesions,and 9 （ 7. 3% ） accompanied with oral mucosal involvement. Most of the eruptions were half-distributed （ 44. 3% ） ,64 patients （ 51. 6% ）had pruritus,which ranged from mild irritation to severe intolerable itching,56 （ 45. 2% ） had no subjective symptoms,4 （ 3. 2% ） had spontaneous pain or tenderness,and 2 had positive family history of lichen planus. The diagnostic accordance rate was 50. 8% . Conclusion Some characteristics exist in sex,age,and clinical manifestation of lichen planus in Hunan province. Systemic and / or local treatment should be taken according to the lesion morphology,localization and subtypes of lichen planus.