Lichen sclerosus in Infant/Neonate
L90.0 – Lichen sclerosus et atrophicus
895454001 – Lichen sclerosus
- Morphea – Indurated; lilac-colored or hyperpigmented border.
- Vitiligo – Well-defined depigmentation, often not in hourglass configuration; lacks signs of atrophy (purpura, telangiectasias, fine wrinkling, and fissures).
- Lichen planus – Look for fine white streaks (Wickham's striae).
- Cicatricial pemphigoid – Look for blisters and erosions, scarring, and stricture formation in later stages.
- Lichen simplex chronicus – Look for lichenification with exaggerated skin markings; may have excoriations.
- Psoriasis – Look for well-demarcated plaques on other body sites.
- Extramammary Paget disease – Look for lichenified to verrucous dry or macerated plaques.
- Sexual abuse – Disrupted hymen, may have an associated sexually transmitted disease, purpura, and bruising outside of atrophic areas; a diagnosis of lichen sclerosus does not exclude concomitant sexual abuse, and social work should investigate when suspicion is high.
- Trauma (eg, straddle injury) – No atrophy, consistent history.
- Scars – Firm, smooth, indurated plaques.
- Cutaneous candidiasis – May have erosions, but no atrophy; erythema and satellite lesions.
- Irritant dermatitis – May have postinflammatory hypopigmentation, pruritus, erythema, and erosions, but no purpura or telangiectasias.
- Bacterial vaginosis – Vulvar pruritus, but no other specific vulvar cutaneous findings.
- Bullous pemphigoid