Инфекции, передаваемые половым путем, и ограниченная склеродермия аногенитальной локализации

Abstract

Objective. To analyze the spectrum of sexually transmitted infections (Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium, and Neisseria gonorrhoeae) in patients with different clinical variants of localized scleroderma (LS) and scleroatrophic lesions in the anogenital area. Patients and methods. We examined 104 patients diagnosed with LS (including guttate morphea, linear scleroderma, scleroatrophic lichen, and atrophoderma of Pasini and Pierini) in V.A.Rakhmanov Clinic of Skin and Venereal Diseases. After clinical and morphological phenotyping, we selected 62 patients (17.7% of males and 82.3% of females) with scleroatrophic lesions in the anogenital area. All patients were tested for sexually transmitted infections, including Human papillomavirus (HPV) (high-risk types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) and herpes simplex virus type 1 and 2 (HSV1/2) using polymerase chain reaction. Results. We found that 71% of patients with scleroatrophic lesions in the anogenital area had chronic infections, including those caused by Chlamydia trachomatis (29.5%), Trichomonas vaginalis (15.9%), Mycoplasma genitalium (13.6%), and Neisseria gonorrhoeae (2.3%). In 38.6% of cases, the development of scleroatrophic lesions was associated with bacterial vaginosis. One-third of patients (33.8%) were found to have high-risk HPV strains (type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) and HSV 1/2. Conclusion. In our opinion, anogenital location of LS can be a marker of chronic infections of the genitourinary system; such patients should be tested for sexually transmitted infections. Keywords: localized scleroderma; scleroatrophic lichen; anogenital location; vulvar lichen; penile lichen; sexually transmitted infections; bacterial vaginosis; herpes simplex virus; human papillomavirus