Paediatric vulval lichen sclerosus: a retrospective study.

Area of Science:

• Dermatology
• Pediatrics
• Gynecology

Background:

• Lichen sclerosus (LS) is a chronic inflammatory skin condition affecting the anogenital area, primarily in prepubertal girls and postmenopausal women.
• The exact cause of LS remains unknown, though several potential etiological factors have been proposed.

Purpose of the Study:

• To evaluate prepubertal-onset vulval lichen sclerosus (VLS) in a pediatric cohort.
• To assess baseline characteristics, clinical presentation, potential contributing factors, and treatment outcomes.

Main Methods:

• Retrospective analysis of case notes for patients under 18 diagnosed with prepubertal-onset VLS.
• Data collected included clinical presentation, comorbidities, family history, treatments, and response to therapy.

Main Results:

• Twenty-six pediatric patients were identified, with a median symptom onset at age 5.
• Identified potential factors included family history, trauma, autoimmune conditions, and hormonal influences.
• A significant number had urinary tract symptoms like incontinence and infections. Most responded to topical therapy, but some with persistent incontinence or those entering puberty had active disease.

Conclusions:

• Thorough assessment is crucial for identifying and managing predisposing factors and comorbidities in VLS.
• Urinary incontinence may contribute to pediatric VLS development and hinder disease control.
• Pediatric VLS can continue into puberty, necessitating long-term monitoring.