Lichen Sclerosus: A Survey of Diagnosis and Management Among Pediatric Dermatologists and Gynecologists

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Christine M Pennesi, Aneka Khilnani, Kalyani S Marathe

    Journal of Drugs in Dermatology : JDD
    |June 4, 2024
    PubMed

    Insights

    Pediatric vulvar and perianal lichen sclerosus (PVPLS) management varies significantly among specialists, with a need for standardized long-term follow-up guidelines despite high diagnostic confidence.

    Area of Science:

    • Dermatology
    • Pediatric Gynecology

    Background:

    • Lichen sclerosus (LS) is a chronic inflammatory skin condition.
    • Pediatric vulvar and perianal lichen sclerosus (PVPLS) requires careful management due to scarring risks.
    • Optimal long-term PVPLS care strategies remain undefined.

    Purpose of the Study:

    • To survey pediatric dermatologists and gynecologists on PVPLS diagnostic and treatment approaches.
    • To assess provider confidence and identify needs for long-term PVPLS management guidance.

    Main Methods:

    • A cross-sectional survey was distributed via the Pediatric Dermatology Research Alliance (PeDRA) and NASPAG.
    • The survey included 35 questions on PVPLS diagnosis, treatment, and follow-up.
    • Data were collected between July 13, 2021, and August 30, 2021.

    Main Results:

    • Most respondents were pediatric/adolescent gynecologists (46%) and pediatric dermatologists (41%).
    • High confidence in PVPLS diagnosis (85%) contrasted with a strong desire for management guidelines (86%).
    • Initial treatments were consistent, but maintenance regimens and follow-up protocols varied, with only 42% recommending lifelong monitoring.

    Conclusions:

    • While initial PVPLS treatment shows consistency, long-term management and follow-up lack uniformity across specialties.
    • Further research is essential to establish evidence-based guidelines for optimal PVPLS management and lifelong monitoring.
    • Standardized protocols are needed to address the chronic nature of PVPLS and its potential persistence into adulthood.
    Abstract

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