聚焦超声治疗外阴慢性单纯性苔藓的研究进展

Research Advances in Focused Ultrasound Therapy for Vulvar Lichen Simplex Chronicus

摘要: 外阴慢性单纯性苔藓是一类以顽固性外阴瘙痒、皮肤色素减退为典型特征的慢性外阴皮肤疾病，局部糖皮质激素为其一线治疗方案，但因需长期维持用药，患者依从性普遍较差，致使病变反复发作，严重降低患者的生活质量。高强度聚焦超声(HIFU)作为新型物理治疗技术，目前已广泛应用于糖皮质激素不耐受或治疗无效的患者，且取得了良好的临床疗效。然而，该技术在治疗前评估、治疗中动态监控、治疗后行为干预及长期随访等环节仍存在诸多亟待解决的问题。本文综述聚焦超声治疗外阴慢性单纯性苔藓的作用机制、临床疗效、影响因素及现存问题，旨在为该疾病的临床实践及未来研究提供参考依据。

Abstract: Vulvar lichen simplex chronicus (VLSC) is a chronic vulvar dermatosis characterized by persistent vulvar pruritus and skin hypopigmentation. Topical corticosteroids serve as the first-line treatment; however, the necessity for long-term maintenance therapy often leads to poor patient adherence, resulting in frequent disease recurrence and a significant decline in quality of life. As a novel physical therapy, high-intensity focused ultrasound (HIFU) has been widely adopted for patients who are intolerant or unresponsive to corticosteroids, demonstrating favorable clinical outcomes. Nevertheless, several challenges remain to be addressed in pre-treatment evaluation, real-time monitoring during therapy, post-treatment behavioral interventions, and long-term follow-up. This article reviews the mechanism of action, clinical efficacy, influencing factors, and existing challenges of focused ultrasound therapy for VLSC, aiming to provide references for clinical practice and future research on this disease.