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Peri-clitoral Epidermal Inclusion Cyst as Initial Presentation of Lichen Sclerosus in a Pediatric Patient

Emily Huebner1, Kate Debiec2, Angela Hernandez2

  • 1University of Washington School of Medicine, Department of Obstetrics and Gynecology, Seattle, Washington; Swedish Medical Center, Department of Obstetrics and Gynecology, Seattle, Washington.

Journal of Pediatric and Adolescent Gynecology
|January 26, 2024
PubMed

Insights

Lichen sclerosus (LS) can cause vulvar masses in children. This case report describes a peri-clitoral epidermal inclusion cyst in a 5-year-old, potentially linked to LS inflammation and itching.

Area of Science:

  • Dermatology
  • Pediatric Surgery
  • Gynecology

Background:

  • Lichen sclerosus (LS) is a chronic inflammatory skin condition affecting the vulva and anogenital region, characterized by itching and hypopigmentation.
  • LS typically presents with skin changes, but a peri-clitoral mass has not been previously documented.

Observation:

  • A 5-year-old girl presented with vulvar itching and a homogenous mass on ultrasound, initially suspected to be clitoromegaly.
  • Clinical examination revealed a soft, mobile, peri-clitoral mass with surrounding hypopigmentation consistent with LS.
  • Surgical excision of the mass was performed, with pathology confirming an epidermal inclusion cyst.

Findings:

  • The peri-clitoral mass was identified as an epidermal inclusion cyst.
  • The patient's symptoms resolved after surgical excision and initiation of topical steroids for LS.

Implications:

  • This case suggests that chronic inflammation and pruritus associated with Lichen sclerosus may lead to the development of peri-clitoral epidermal inclusion cysts in pediatric patients.
  • Further investigation is warranted for clitoromegaly without hormonal causes to explore potential links to inflammatory dermatoses like LS.
Abstract

Keywords:
Epidermal inclusion cystPediatricVulvar lichen sclerosus

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