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已发表论文
外阴硬化性苔藓、扁平苔藓和慢性单纯性苔藓的差异性临床特征：一项基于 1355 例患者的比较研究
Authors Hu Q, Sun K, Liu L, He Y, Shao Y, Liu T, Yang K , Yang M, Chang J
Received 9 October 2025
Accepted for publication 2 January 2026
Published 31 January 2026 Volume 2026:19 570982
DOI https://doi.org/10.2147/CCID.S570982
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Jeffrey Weinberg
Qiang Hu,1,2,* Kailü Sun,2,* Lin Liu,2 Yuexi He,2,3 Yakun Shao,2 Teng Liu,2 Kun Yang,2 Min Yang,2 Jianmin Chang1,2
1Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Dermatology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianmin Chang, Email changjm0417@126.com
Background: Vulvar lichen sclerosus (VLS), vulvar lichen planus (VLP), and vulvar lichen simplex chronicus (VLSC) are inflammatory dermatoses with overlapping clinical features, posing diagnostic challenges. VLS and VLP carry malignant potential, unlike VLSC. Comparative studies are limited despite frequent misclassification.
Objective: To compare the clinical characteristics of VLS, VLP, and VLSC and identify distinguishing diagnostic features.
Methods: A retrospective study was conducted on clinical data from patients diagnosed with VLS, VLP, or VLSC at the Beijing Hospital Vulvar Clinic (March 2017-August 2024). Epidemiological data, symptoms, and physical findings were compared.
Results: Patients with VLP had a significantly higher median onset age (44 years) than VLS (30 years) or VLSC (34 years) (P< 0.001). Diagnostic delay was longest in VLS (median 5 years vs 3 years for VLP/VLSC). Pruritus prevalence and intensity (median Numerical Rating Scale [NRS]) were highest in VLSC (100%; NRS 7), followed by VLS (92%; NRS 5) and VLP (60%; NRS 2). Pain was most frequent in VLP (79%) vs VLS (14%) and VLSC (< 1%). VLSC patients reported the highest mean Dermatology Life Quality Index scores (8.67), driven by severe pruritus. Sexual dysfunction was common in both VLS (81%) and VLP (85%). Anatomically, VLS primarily affected the clitoris, labia minora, and interlabial sulci; VLSC predominantly involved the labia majora and perianal region. Vaginal introitus involvement characterized VLP (90%). Lesion morphology differed: VLS featured white patches (84%) and lichenification (61%), VLP erosion (76%), and VLSC marked lichenification (89%).
Conclusion: VLS, VLP, and VLSC exhibit distinct differences in age of onset, clinical manifestations, lesion morphology, and anatomical distribution despite clinical overlap. Recognizing these features facilitates accurate diagnosis, guides individualized treatment, improves long-term outcomes, and enables early detection of malignant potential in VLS/VLP.
Keywords: vulvar lichen sclerosus, vulvar lichen planus, vulvar lichen simplex chronicus
1Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Dermatology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 3Department of Dermatology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianmin Chang, Email changjm0417@126.com
Background: Vulvar lichen sclerosus (VLS), vulvar lichen planus (VLP), and vulvar lichen simplex chronicus (VLSC) are inflammatory dermatoses with overlapping clinical features, posing diagnostic challenges. VLS and VLP carry malignant potential, unlike VLSC. Comparative studies are limited despite frequent misclassification.
Objective: To compare the clinical characteristics of VLS, VLP, and VLSC and identify distinguishing diagnostic features.
Methods: A retrospective study was conducted on clinical data from patients diagnosed with VLS, VLP, or VLSC at the Beijing Hospital Vulvar Clinic (March 2017-August 2024). Epidemiological data, symptoms, and physical findings were compared.
Results: Patients with VLP had a significantly higher median onset age (44 years) than VLS (30 years) or VLSC (34 years) (P< 0.001). Diagnostic delay was longest in VLS (median 5 years vs 3 years for VLP/VLSC). Pruritus prevalence and intensity (median Numerical Rating Scale [NRS]) were highest in VLSC (100%; NRS 7), followed by VLS (92%; NRS 5) and VLP (60%; NRS 2). Pain was most frequent in VLP (79%) vs VLS (14%) and VLSC (< 1%). VLSC patients reported the highest mean Dermatology Life Quality Index scores (8.67), driven by severe pruritus. Sexual dysfunction was common in both VLS (81%) and VLP (85%). Anatomically, VLS primarily affected the clitoris, labia minora, and interlabial sulci; VLSC predominantly involved the labia majora and perianal region. Vaginal introitus involvement characterized VLP (90%). Lesion morphology differed: VLS featured white patches (84%) and lichenification (61%), VLP erosion (76%), and VLSC marked lichenification (89%).
Conclusion: VLS, VLP, and VLSC exhibit distinct differences in age of onset, clinical manifestations, lesion morphology, and anatomical distribution despite clinical overlap. Recognizing these features facilitates accurate diagnosis, guides individualized treatment, improves long-term outcomes, and enables early detection of malignant potential in VLS/VLP.
Keywords: vulvar lichen sclerosus, vulvar lichen planus, vulvar lichen simplex chronicus