Lichen sclerosus et atrophicus-a review of 15 cases in young girls

Abstract

We report a series of 15 girls who developed lichen sclerosus between the ages of 18 months and 9 years. Only five of these were initially referred to a dermatologist and the diagnosis was made promptly in these cases on the first visit to the clinic. The diagnosis was usually delayed under disciplines less familiar with the disease. We encountered a high level of parental anxiety regarding the possibility of misdiagnosis of lichen sclerosus as childhood sexual abuse. Dysuria and pain on defaecation were common and prominent symptoms which have not previously been stressed adequately. The clinical features were diagnostic in all our cases, although three had undergone vulval biopsy under general anaesthesia prior to being seen by a dermatologist. There was a trend towards improvement with increasing age.