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Lichen sclerosus et atrophicus in children
1Department of Pediatrics, University of Iowa, Iowa City.
American Journal of Diseases of Children (1960)
|September 1, 1991
Summary
Lichen sclerosus et atrophicus is a chronic anogenital skin condition in children, presenting with characteristic lesions and sometimes causing pain, bleeding, or anal stenosis. While it can mimic abuse, lesions may resolve in childhood but can persist into adulthood.
Area of Science:
- Pediatric Dermatology
- Genitourinary Medicine
Background:
- Lichen sclerosus et atrophicus (LSA) is a chronic, benign inflammatory condition affecting the anogenital region.
- It commonly presents in prepubertal girls and less frequently in boys, with characteristic skin changes.
Purpose of the Study:
- To describe the clinical presentation, associated conditions, and treatment outcomes of LSA in pediatric patients.
- To highlight the diagnostic challenges and potential misinterpretations of LSA, particularly its resemblance to sexual abuse.
Main Methods:
- Retrospective case series analysis of 11 pediatric patients (10 girls, 1 boy) diagnosed with LSA.
- Clinical data collection included symptoms, physical findings, associated conditions, and treatment responses.
Main Results:
- Characteristic lesions included hypo-pigmented plaques in a figure-of-8 pattern around the anogenital area, with fissures and ulcers noted in many.
- Symptoms reported were painful defecation and anogenital bleeding; two patients developed anal stenosis.
- LSA mimicked sexual abuse, leading to investigations in some cases. Lesions resolved in three patients by ages 9-12, but persistence into adulthood is possible.
Conclusions:
- Lichen sclerosus et atrophicus presents with distinct anogenital findings in children and requires careful diagnosis to avoid confusion with abuse.
- Management should address symptoms and potential complications like anal stenosis, with awareness of possible long-term persistence.