Abstract

INTRODUCTION
Lichen sclerosus (LS) is a chronic skin disorder with a predilection for the anogenital area. The disease is mostly seen in prepubertal and postmenopausal females. The lesions present as sharply demarcated white plaques encircling the vagina and anus. The atrophic form can lead to scarring of the affected area.
MATERIAL AND METHODS
Retrospective analysis of hospital records of children (aged 1-18 years) seen at the Department of Dermatology and Allergy Centre in Odense from October 1998 to November 2010 with a definite clinical diagnosis of anogenital LS with/without a confirming biopsy.
RESULTS
A total of 35 girls and one boy were diagnosed with anogenital LS. The diagnostic delay was 17 months. Pruritus, dysuria, bleeding and constipation were the dominant complaints, while one patient was asymptomatic. Referral was made by general practitioners, private dermatologists and paediatricians. Sexual abuse was suspected in five cases. Ten patients underwent biopsy confirming LS. Before a definite diagnosis was given, many children were extensively treated with various topical and oral agents. In our outpatient clinic, 30 children were treated with potent/ultra-potent corticosteroids and five patients were treated with calcineurin inhibitors.
CONCLUSION
General practitioners may overlook this disorder despite characteristic clinical features and effective symptomatic treatment. Diagnostic delay is a significant problem for both patient and family, and the lesions may mimic the findings of sexual abuse. Potent corticosteroids are very effective in symptomatic treatment.
FUNDING
not relevant.
TRIAL REGISTRATION
not relevant.

Authors

Jensen LS, Bygum A

Institution

Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark. lisesoldbro@gmail.com

Source

Danish medical journal 59:5 2012 May pg A4424

MeSH

Adolescent
Adrenal Cortex Hormones
Child
Child, Preschool
Delayed Diagnosis
Female
Follow-Up Studies
Humans
Immunosuppressive Agents
Infant
Lichen Sclerosus et Atrophicus
Male
Retrospective Studies
Tacrolimus
Treatment Outcome
Vulvar Lichen Sclerosus

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

22549488