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Abstract(s)
Introdução: O líquen plano é uma dermatose de caráter inflamatório crónico e recidivante
mediada por células T. Esta doença dermatológica envolve unhas, cabelos, pele e/ou
membranas mucosas. Quanto à região vulvar, esta pode ser afetada individualmente ou
associada a uma lesão cutânea geral, e pode ser atingida só a pele vulvar, apenas as mucosas
ou a pele e as mucosas. Sugere-se que o LP vulvar tenha uma predisposição genética e
diversos fatores, como infeções víricas, doenças autoimunes e fármacos podem estar
relacionadas com o aparecimento da doença. O diagnóstico é clínico e histológico e o
tratamento de primeira linha é a aplicação de corticoterapia tópica.
Objetivo: Com esta dissertação tenciona-se reunir o conhecimento atual existente sobre
esta doença relativamente a epidemiologia, etiopatogenia, doenças associadas,
manifestações clínicas, diagnóstico, diagnóstico diferencial, complicações, tratamento e ao
prognóstico.
Metodologia: A pesquisa bibliográfica foi realizada na plataforma PubMed, EBSCO e
Cochrane Library entre setembro de 2021 e março de 2022.
Resultados e Conclusões: Mulheres com doenças vulvares necessitam de cuidados
específicos, considerando não apenas os aspetos genitais, mas também as alterações
cutâneas. A biópsia de qualquer lesão atípica é essencial para excluir o desenvolvimento de
malignidade. Como o LP vulvar pode ser mais sujeito a alterações malignas, esses pacientes
necessitam de vigilância prolongada. O tratamento deve começar com os corticosteroides
tópicos ultrapotentes antes de se adicionar ou usar outros fármacos. A abordagem cirúrgica
pode ser necessária no caso de as pacientes apresentarem aderências e cicatrizes vaginais
ou vulvares sintomáticas. A terapia de ultrassom focalizado e a terapia fotodinâmica tópica
são duas alternativas de tratamento que mostram resultados promissores. As pacientes com
o LP vulvar apresentam um comprometimento moderado na qualidade de vida que não
melhora consideravelmente com o tratamento. O tratamento atual não é suficiente para
minimizar a carga pessoal da doença no dia a dia. Mais pesquisas devem ser feitas para se
poder estimar a utilidade de diferentes modalidades terapêuticas utilizadas para controlar
esta doença.
Introduction: Lichen planus is a chronic and relapsing inflammatory dermatosis mediated by T cells. This dermatological disease involves nails, hair, skin and/or mucous membranes. The vulvar region can be affected individually or it can be associated with a general lesion, and it can reach only the vulvar skin, only mucous membranes or skin and mucous membranes. It is suggested that vulvar LP has a genetic predisposition and several factors, such as viral infections, autoimmune diseases and drugs may be related to the appearance of the disease. The diagnosis is clinical and histological and the first-line treatment is the application of topical corticosteroids. Objectives: This dissertation intends to gather the actual existing knowledge about this disease in terms of epidemiology, etiopathogenesis, association of diseases, clinical manifestations, diagnosis, differential diagnosis, complications, treatment and prognosis. Methodology: The literature search was carried out on the PubMed, EBSCO and Cochrane Library platform between September 2021 and March 2022. Discussion and Conclusion: Women with vulvar diseases need specific care, considering not only genital aspects, but also skin changes. Biopsy of any atypical lesion is essential to exclude the development of malignancy. As the vulvar LP may be more prone to malignant changes, these patients require prolonged surveillance. Treatment should begin with ultrapotent topical corticosteroids before adding or using other drugs. A surgical approach may be necessary if patients have adhesions and symptomatic vaginal or vulvar scarring. Focused ultrasound therapy and topical photodynamic therapy are two treatment alternatives that show promising results. Patients with vulvar LP have a moderate impairment in quality of life that does not improve considerably with treatment. The current treatment is not enough to minimize the day-to-day burden of disease. More research should be done in order to estimate the usefulness of different therapeutic modalities used to control this disease.
Introduction: Lichen planus is a chronic and relapsing inflammatory dermatosis mediated by T cells. This dermatological disease involves nails, hair, skin and/or mucous membranes. The vulvar region can be affected individually or it can be associated with a general lesion, and it can reach only the vulvar skin, only mucous membranes or skin and mucous membranes. It is suggested that vulvar LP has a genetic predisposition and several factors, such as viral infections, autoimmune diseases and drugs may be related to the appearance of the disease. The diagnosis is clinical and histological and the first-line treatment is the application of topical corticosteroids. Objectives: This dissertation intends to gather the actual existing knowledge about this disease in terms of epidemiology, etiopathogenesis, association of diseases, clinical manifestations, diagnosis, differential diagnosis, complications, treatment and prognosis. Methodology: The literature search was carried out on the PubMed, EBSCO and Cochrane Library platform between September 2021 and March 2022. Discussion and Conclusion: Women with vulvar diseases need specific care, considering not only genital aspects, but also skin changes. Biopsy of any atypical lesion is essential to exclude the development of malignancy. As the vulvar LP may be more prone to malignant changes, these patients require prolonged surveillance. Treatment should begin with ultrapotent topical corticosteroids before adding or using other drugs. A surgical approach may be necessary if patients have adhesions and symptomatic vaginal or vulvar scarring. Focused ultrasound therapy and topical photodynamic therapy are two treatment alternatives that show promising results. Patients with vulvar LP have a moderate impairment in quality of life that does not improve considerably with treatment. The current treatment is not enough to minimize the day-to-day burden of disease. More research should be done in order to estimate the usefulness of different therapeutic modalities used to control this disease.
Description
Keywords
Diagnóstico Etiopatogenia Genital Lichen Planus Tratamento Vulvar