Dermatolojik açıdan labial füzyon: prospektif çalışma

Abstract

Amaç: Labial füzyon, prepubertal kızlarda sık görülen bir durumdur ve çeşitli komplikasyonları vardır. Bazı dermatolojik durumlar bu hastalık için etiyolojik faktör olarak bildirilmiştir. Bu çalışmanın amacı çocuklarda labial füzyonun etiyolojik faktörlerini dermatolojik olarak değerlendirmek; sosyodemografik ve çevresel verilerini sağlıklı çocuklarınkilerle karşılaştırmaktır.

Materyal ve Metod: Bu kesitsel prospektif çalışmada, 23 tane labial füzyon olgusu ve 49 tane yaş cinsiyetine uygun sağlıklı denekler dermatolojik açıdan değerlendirildi ve tümüne bir anket uygulandı.

Bulgular: Kontrol grubunda; annelerin %34,7'si üniversiteden, labial füzyonlu çocuklarda %34,8'i ilkokuldan mezun olmuştur. Atopik aile öyküsü ve hastaların atopik hastalık öyküsü, labial füzyon grubunda sağlıklı kontrollere göre daha yüksekti (p <0.001, p <0.001). Labial füzyon grubundaki olguların %60.9’unda (n:14) ortalama 1.26 ± 1.32 (ortanca: 1.00) hafta öncesinde pre-eritematöz lezyon şikayeti mevcuttu.  Alkol bazlı bebek mendillerinin kullanımı labial füzyonlu grupta daha yüksekti (p = 0.035).

Sonuçlar: Annelerin eğitim düzeyi düşük olan; aile ve kişisel atopik öyküleri ve hastalıkları bulunan; alkol bazlı bebek mendilleri sık kullanılan çocuklarda labial füzyon saptanmaktadır. Ayrıca, genital bölgede eritemi olan çocuklar labial füzyonun erken tanısı ve önlenebilmesi için muayeneden sonraki ilk bir ay boyunca takip edilmelidir.

Keywords

• labial fusion,atopic disease,diaper

Dermatological aspect of labial fusion: a prospective study

Öz

Objective: Labial fusion is a common condition in prepubertal girls and has several complications. Some dermatological conditions were reported as etiologic factor for this disease. The aim of this study is to evaluate the etiological factors of labial fusion in children through a dermatologic view and to compare the socio-demographic, and environmental data of patients with healthy children.

Material and Method: In this cross sectional prospective study, 23 patients with labial fusion and 49 age-sex matched healthy subjects were questioned and examined from dermatological aspect and assessed by a questionnaire.

Results: In the control group; 34.7% of mothers were graduated from university and in children with labial fusion 34.8% of mothers were graduated from primary school. The atopic family history and history of atopic diseases of patients were higher in labial fusion group when compared with healthy controls. (p<0.001, p <0.001) There were complaints of pre-erythematous lesions with a mean of 1.26±1.32 (median: 1.00) weeks before labial fusion in 60.9% (n:14) of  patients with labial fusion. The alcohol based baby wipes usage was higher in group with labial fusion (p = 0.035).

Conclusions: Labial fusion can be diagnosed in children of mothers with lower grade education, with family and personal atopic history and diseases, and frequent usage of alcohol based baby wipes. Also erythema in genital area could need follow-up in first month of visit for prevention or early diagnosis of  labial fusion.

Anahtar Kelimeler

• bebek bezi,atopik hastalıklar,labial füzyon

Kaynakça

1. 1. Leung AK, Robson WL, Tay-Uyboco J. The incidence of labial fusion in children. J Paediatr Child Health 1993;29(3):235-6.
2. 2. Bacon JL. Prepubertal labial adhesions: evaluation of a referral population. Am J Obstet Gynecol 2002; 187(2):327-31.
3. 3. Gaudens DA, Moh-Ello N, Fioqbe M et al. Labial fusion in the paediatric surgery department of Yopougon University hospital (Cote d’Ivoire): 108 cases. Sante 2008; 8(1): 35-8 (French)
4. 4. Omar HA. Management of labial adhesions in prepubertal girls. J PediatrAdolescGynecol 2000;13(4):183–5.
5. 5. Mayoglou L, Dulabon L, Martin-Alguacil N. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. J PediatrAdolescGynecol 2009;22(4): 247-50.
6. 6. Herieka E, Dhar J. Labial adhesions following severe primary genital herpes. Sex Transm Infect 2001;77(1):75.
7. 7. Norian JM, Stratton P. Labial fusion: a rare complication of chronic graft-versus-host disease. Obstet Gynecol. 2008;112(2):437-9.
8. 8. Acer T, Otgün I, Oztürk O, Kocabaş T, Tezcan AY, Cirak A. Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors. J Pediatr Surg. 2012 47(10):1913-8.

9. 9. Cağlar MK. Serum estradiol levels in infants with and without labial adhesions: the role of estrogen in the etiology and treatment. PediatrDermatol 2007; 24(4):373-5.
10. 10. Gibbon KL, Bewley AP, Salisbury JA. Labial fusion in children: a presenting feature of genital lichen sclerosus. PediatrDermatol 1999; 16(5):388-91.
11. 11. Hanifin JM. Atopic Dermatitis in infants and children. Pediatric Clinics North Am 1991; 38(4): 763 – 89.
12. 12. Seymour JL, Keswick BH, Hanifin JM, Jordan WP, Milligan MC. Clinical effects of diaper types on the skin of normal infants and infants with atopic dermatitis. J Am Acad Dermatol 1987;17(6): 988 – 97.
13. 13. Ehretsmann C, Schaefer P, Adam R. Cutaneous tolerance of baby wipes by infants with atopic dermatitis, and comparison of the mildness of baby wipe and water in infant skin. J Eur Acad Dermatol Venereol 2001;15: 16-21.