Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which may present in a prepubertal or adolescent patient. The most popular theories are its autoimmune and genetic conditioning, although theories concerning hormonal and infectious etiology have also been raised. The most common presenting symptoms of VLS is vulva pruritus, discomfort, dysuria and constipation. In physical examination, a classic “Figure 8” pattern is described, involving the labia minora, clitoral hood, and perianal region. The lesions initially are white, flat-topped papules, thin plaques, or commonly atrophic patches. Purpura is a hallmark feature of VLS. The treatment includes topical anti-inflammatory agents and long-term follow-up, as there is a high risk of recurrence and an increased risk of vulvar cancer in adult women with a history of lichen sclerosus. This article reviews vulvar lichen sclerosus in children and provides evidence-based medicine principles for treatment in the pediatric population. A systematic search of the literature shows recurrence of VLS in children. Maintenance regimens deserve further consideration.

Polycystic ovary syndrome is an endocrinopathy that mainly affects adolescent girls and young women of childbearing age. In girls, the presence of clinical and biochemical symptoms of hyperandrogenism should be particularly considered. The role of vitamin D deficiency in insulin resistance, inflammation, dyslipidemia, and obesity, i.e. in diseases associated with PCOS, has been investigated, which may suggest its involvement in the pathophysiology of the syndrome. Leptin has been shown to stimulate the formation of FGF23 in bones. There is a relationship between the incidence of dyslipidemia, adipose tissue mass and the concentration of fibroblast growth factor 23. The main aim of the presented research project is to assess the concentration of vitamin D, calcium, and selected hormones as well as the concentration of adipokines (leptin) in girls diagnosed with polycystic ovary syndrome.Materials and methodsThe study included a population of 85 girls and young women aged 14 to 22 years. The study group included 37 girls who were diagnosed with polycystic ovary syndrome according to the modified Rotterdam’s criteria. The control group consisted of 48 completely healthy girls. In the first stage of the study participants were required to answer background questions. Next, anthropometric measurements were performed. The laboratory tests assessed: leptin, FGF23, FSH, SHGB, total testosterone, DHEA-S, 25-OH-D3, PTH, calcium, androstadiene, AMH, glucose, insulin.ResultsThe vitamin D level in the group with polycystic ovary syndrome was lower than in the control group, but there was no statistically significant difference. The level of anti-Müllerian hormone was significantly higher in the group of girls diagnosed with PCOS compared to the control group. Statistically significant differences between both groups were also noted in the HOMA-IR value. The concentration of calcium, parathyroid hormone, FGF23 and leptin in the study and control groups showed no statistically significant difference.ConclusionsIn the studied group of girls with PCOS, no correlation between the level of vitamin D and selected parameters such as: AMH leptin, HOMA-IR and FGF23 was confirmed. On this basis, it can be assumed that additional vitamin D supplementation would not reduce the symptoms of polycystic ovary syndrome.

Objectives: Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease of unclear etiology. Recent studies show that 15-34% of cases in adult women and 14% in girls coexist with allergies or autoimmune diseases, among others -celiac disease (CD). Most of the research on the coexistence of VLS and autoimmune diseases has been carried out on a group of adult women. Literature data on this issue are very scarce. Material and methods:The presented work is a pioneering project in which we tried to elucidate a possible relationship between celiac disease and lichen sclerosus in girls. The aim of the research was to study the antibodies characteristic of celiac disease in girls with VLS. The control group consisted of 35 heathy adolescent girls and the study group consisted of 20 girls aged 2-18 years old diagnosed with vulvar lichen sclerosus recruited at the Gynecological Clinic for Girls at the Women's Health Center in Katowice.Results: There were no significant differences in the concentrations of antibodies characteristic for CD in the blood serum between the studied groups. Conclusions:The main limitation of our study was the small size of the study group. It is therefore legitimate to conduct further research on a larger study group to find the mutual correlations between the analyzed antibodies and the onset and the course of VLS in girls. The finding of a positive correlation between the coexistence of VLS and CD may prevent potentially serious, long-term complications.

The recommendations present current methods of treatment that may be subject to modification and change in justified cases, after careful analysis of the given clinical situation. In the future, this may be the basis for their modification and updating. EPIDEMIOLOGYMost teenage pregnancies are related to unprotected intercourse and early sexual initiation. It is a global problem, 259 Agnieszka Drosdzol-Cop et al., The PTGiP's Expert Group Recommendations regarding adolescent pregnancy www. journals.viamedica.pl/ginekologia_polskawith nearly 16 million teenage girls aged 15-19 and two million girls under 15 becoming pregnant each year. According to the United Nations Children's Fund (UNICEF) data for highly developed countries, the country with the lowest percentage of births per 1,000 pregnant women under 20 is South Korea -2.9, and the highest in the USA -52.1. For Poland the indicator is 18.7 [2][3][4]. It should be remembered that adolescent pregnancy is associated with more complications and risk of maternal and child death. Based on the available data, it is the leading cause of death for adolescents aged 15-19 years in the world [5][6][7]. Increased mortality is also associated with poorly performed abortions that led to permanent damage to health, complications or outright death, it is reported that 5.6 million abortions are performed annually on girls aged 15-19, of which 3.9 million are improperly performed [1][2][3]7].The young age of the mother leads to an increased risk of systemic infection, eclampsia, puerperal endometritis, premature birth and is also associated with low birth weight and severe neonatal morbidity [5].It is worth noticing that according to a World Health Organization (WHO) report, in Scandinavian countries where access to contraception and abortion is very easy, it is reflected in the rate of underage pregnancies, which is much lower compared to other countries [1].General Statistics of Poland (GUS, Główny Urząd Statystyczny) data for 2020, state that in Poland mothers aged 19 and under gave birth to 7118 children. This compares to 11,230 in 2016 for the same age group. Year on year, we are seeing a downward trend in our country [6].

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