Lichen Sclerosus et Atrophicus in Children and Young Adults

Helm, Klaus F.; Gibson, Lawrence E.; Muller, Sigfrid A.

doi:10.1111/j.1525-1470.1991.tb00294.x

Cited by 46 publications

(24 citation statements)

References 21 publications

(12 reference statements)

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“…Neben äußerst beeinträchtigenden Symptomen wie quälendem Juckreiz, Schmerzen beim Koitus, Blutungen und Einrissen der Haut mit schweren behindernden Vernarbungen des Genitales im Endstadium, besteht bei Erwachsenen die Gefahr der Entwicklung eines Plattenepithelkarzinoms [16]. Eine Spontanremission bei Kindern ist beschrieben, wird jedoch kontrovers diskutiert [10].…”

Section: Einführungunclassified

“…Eine überzufällig häufig auftretende Erstmanifestation eines LSAV in Phasen der hormonellen Umstellung wie Menarche, Schwangerschaft, Menopause wird kontrovers diskutiert. Helm und Mitarbeiter [10] konnten bei 52 Kindern und jungen Frauen diesbezüglich keine prognostische Relevanz feststellen. Die von uns behandelten Mädchen befanden sich alle im prämenarchen Alter.…”

Section: Diskussionunclassified

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Kryochirurgie – ultima ratio oder chirurgische Alternative beim vulvären Lichen sclerosus et atrophicus (LSAV)?

Kastner

Altmeyer

2003

J Deutsche Derma Gesell

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Section: Einführungunclassified

Section: Diskussionunclassified

Kryochirurgie – ultima ratio oder chirurgische Alternative beim vulvären Lichen sclerosus et atrophicus (LSAV)?

Kastner

Altmeyer

2003

J Deutsche Derma Gesell

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“…8 In contrast, 18% of children develop other long-term sequelae, including scarring, adhesions, and atrophy. 2,3,6,7,9 The treatment of lichen sclerosus in pediatric patients has been largely unsatisfactory. Mild-potency topical corticorsteroids and bland emollients may reduce pruritus but generally do not alter the course of the disease.…”

mentioning

confidence: 99%

Ultrapotent Topical Corticosteroid Treatment of Childhood Genital Lichen Sclerosus

Garzon¹,

Paller²

1999

Arch Dermatol

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To observe the clinical effects of shortterm application of ultrapotent topical corticosteroid on symptomatic genital lesions of lichen sclerosus in pediatric patients.Design: Case series of 10 prepubertal girls with genital lichen sclerosus. Ultrapotent topical corticosteroids were applied twice daily for 6 to 8 weeks and patients were reexamined at completion of treatment. Long-term follow-up over 6 months to 3 years. Setting: Pediatric dermatology clinic (referral center).Patients: Ten prepubertal girls with typical clinical features of genital and/or perianal lichen sclerosus.Intervention: Topical ultrapotent corticosteroid ointment was applied sparingly to affected areas for 6 to 8 weeks.Main Outcome Measure: Improvement of erythema, whitening erosions, and atrophy. Subjective improvement of symptoms.Results: All patients showed partial or total subsistence of signs and symptoms of lichen sclerosus. Frequency and severity of recurrences varied, but patients responded within a few days to reapplication of ultrapotent topical corticosteroid. No significant adverse effects were noted after the initial 6-to 8-week course of therapy or during the 6-month to 3-year follow-up period. Conclusion:A 6-to 8-week course of ultrapotent topical corticosteroid is a safe and effective treatment for genital lichen sclerosus in pediatric patients.

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“…The course of LS in children has been described as “self‐limiting,” with the disappearance of signs and symptoms at puberty when a high estrogen state is reached 22 . Helm et al 33 . reported the resolution of LS in 44% of their patients.…”

Section: Discussionmentioning

confidence: 99%

Lichen sclerosus mistaken for child sexual abuse

2005

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A 3‐year‐old girl presented to the primary care clinic at King Abdulaziz Medical City (KAMC) with asymptomatic white discoloration of the vulva of 3 months’ duration. Dysuria, genital itching, and vaginal discharge followed 2 months later. The discharge was yellowish‐greenish in color and occasionally associated with blood‐tinged staining of the underwear. The mother had noted that the genital skin changes had worsened in the last 2 weeks and that the genital itching and dysuria had become more frequent. There was no history of trauma, behavioral problems, abnormal sexual behaviour, encopresis, or any underlying disease. On questioning the mother, the possibility of sexual abuse could not be ruled out as she reported that the father was drug and alcohol dependent and behaved inappropriately when under the influence of these factors. Because of this possibility, the girl and her parents were referred to the suspected child abuse and neglect (SCAN) team at KAMC for further evaluation. The physician, social worker, and child psychiatrist interviewed the girl, her three older brothers, and the parents separately. The girl and her siblings denied any abnormal touching by an adult. The mother reported that she and the father had been separated for 1 year; however, the couple had been reunited for the last month and were currently living together. The mother linked the appearance of the genital changes to the time the father returned; however, no definite history of sexual abuse was obtained. The father denied any sexual or other abnormal encounter with the child. On examination, the child was well developed and well nourished, cooperative, and showed no abnormal fear of genital or anal examination. Genital examination revealed sharply demarcated, hypopigmented, atrophic plaques symmetrically surrounding the labia majora (Fig. 1). Three sharply demarcated, 0.5 cm, nonpalpable, reddish purpuric macules on the medial aspect of both the labia majora and the base of the clitoris were noted (Fig. 2). Two sharply defined healing erosions were noted on the left side distal to the introitus. The hymenal ring could not be seen, but the hymenal orifice was not dilated. The introitus and the anus appeared normal. Because of the genital findings and the mother's concerns, the possibility of sexual abuse was contemplated. Extensive laboratory testing for sexually transmitted diseases, including syphilis, chlamydia, human immunodeficiency virus, and gonorrhea, were negative. Urine analysis and culture were negative. Routine vaginal culture grew group B β‐hemolytic streptococcus, and the patient was treated with amoxicillin‐clavulanate orally for 10 days. Due to a lack of evidence of sexual abuse, the SCAN team decided to follow up the child and to investigate further before reporting to the protective agency. 1 Photograph of the vulva showing atrophic, hypopigmented, sharply defined plaques 2 Photograph of the vulva showing three sharply demarcated purpuric macules on both the labia majora and the base of the clitoris An arrang...

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Lichen Sclerosus et Atrophicus in Children and Young Adults

Cited by 46 publications

References 21 publications

Kryochirurgie – ultima ratio oder chirurgische Alternative beim vulvären Lichen sclerosus et atrophicus (LSAV)?

Kryochirurgie – ultima ratio oder chirurgische Alternative beim vulvären Lichen sclerosus et atrophicus (LSAV)?

Ultrapotent Topical Corticosteroid Treatment of Childhood Genital Lichen Sclerosus

Lichen sclerosus mistaken for child sexual abuse

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