Lichen sclerosus et atrophicus in children
V. Loening-Baucke
Department of Pediatrics, University of Iowa, Iowa City.
The symptoms, findings, associated conditions, and treatment of lichen
sclerosus et atrophicus were studied in 10 girls and one boy. Lichen
sclerosus et atrophicus is a benign but chronic condition of the anogenital
area of girls and, less frequently, of boys. The characteristic lesions are
hypo-pigmented plaques in a figure-of-8 pattern surrounding the vulva and
anus and often involving the natal cleft. The affected hypopigmented skin
is sharply demarcated from the normal skin. Hemorrhagic, bullous lesions
are uncommon. Fissures and ulcers are seen on the labia, between the labia,
and on the perineum, anus, and natal cleft in many children and on the
glans penis in boys. Lichen sclerosus et atrophicus causes painful
defecation and anal and vulval bleeding. In two patients, one girl and one
boy, anal stenosis due to lichen sclerosus et atrophicus and laxative
treatment developed. Lichen sclerosus et atrophicus mimics sexual abuse and
has led to false accusation and investigations. The anogenital lesions
cleared in three patients at the ages of 9, 11, and 12 years, but lesions
can persist into adulthood.
