Vulvovaginal involvement in toxic epidermal necrolysis: A retrospective study of 40 cases
Vulvovaginal involvement in toxic epidermal necrolysis: A retrospective study of 40 cases
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DOI：
10.1016/s0029-7844(97)00596-6
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发表时间：
1998-02-01
影响因子：
7.2
通讯作者：
Paniel, BJ
中科院分区：
文献类型：
--
作者：
Meneux, E;Wolkenstein, P;Paniel, BJ
目的：为了确定发病率，特点，外阴阴道病变中毒性epidermal necrolization.Methods：急性生殖器病变进行了回顾性研究，在40名妇女住院中毒性epidermal necrolizationin皮肤科重症监护病房。一份调查问卷被发送，以评估后遗症及其对性活动的影响。检查和手术治疗的患者提出了有症状的后遗症。结果：40例患者中有28例报告生殖器病变的急性期中毒性表皮坏死松解症。急性期未进行特殊治疗。在5例病例中观察到后遗症，其中3例涉及下生殖道，2例仅涉及外阴。2例仅累及外阴的患者未尝试任何性活动。另3例外阴和阴道均有病变，不能正常性交。三名患者中有两名接受了手术治疗。1例患者成功性交，但手术未能缓解性交困难。结论：生殖器受累是常见的中毒性表皮坏死松解症，但很少导致症状性后遗症。由于外阴阴道管狭窄，有时需要手术治疗粘连以恢复性活动。由于手术后疼痛缓解的部分效果，应尝试预防方法。(C)1998年由美国妇产科医师学会出版。
Objective: To determine the incidence, features, and surgical treatment of vulvovaginal lesions in toxic epidermal necrolysis.Methods: Acute genital lesions were studied retrospectively in 40 women hospitalized for toxic epidermal necrolysis in a dermatologic intensive care unit. A questionnaire was sent to evaluate sequelae and their effects on sexual activity. Examination and surgical treatment were proposed to patients with symptomatic sequelae.Results: Twenty-eight of the 40 patients reported genital lesions during the acute phase of toxic epidermal necrolysis. No specific treatment was carried out during the acute period. Sequelae were observed in five cases, of which three involved the lower genital tract and two the vulva exclusively. The two patients with exclusive vulval involvement did not attempt any sexual activity. The other three patients with both vulval and vaginal lesions were unable to have normal sexual intercourse. Two of the three patients were treated surgically. One patient succeeded in having intercourse, but surgery failed to relieve dyspareunia.Conclusion: Genital involvement is frequent during toxic epidermal necrolysis but rarely leads to symptomatic sequelae. Surgery for synechiae is sometimes necessary to recover sexual activity because the vulvovaginal canal is stenotic. Because of the partial effect on pain relief after surgery, a preventive approach should be tried. (C) 1998 by The American College of Obstetricians and Gynecologists.).