ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferencesInformation for PatientsView all Images (22)
Lichen sclerosus in Infant/Neonate
See also in: External and Internal Eye,Anogenital
Other Resources UpToDate PubMed

Lichen sclerosus in Infant/Neonate

See also in: External and Internal Eye,Anogenital
Contributors: Kudakwashe K. Maloney MD, MPhil, Craig N. Burkhart MD, Dean Morrell MD, Belinda Tan MD, PhD, Lowell A. Goldsmith MD, MPH, Nancy Esterly MD
Other Resources UpToDate PubMed

Synopsis

Lichen sclerosus is a chronic dermatosis of uncertain etiology. It is very rare in infants. Lesions occur mostly on the genitalia, perineum, or perianal skin, but they can appear anywhere. Because of atrophy and hemorrhage, the disease can easily be mistaken for sexual abuse.

Codes

ICD10CM:
L90.0 – Lichen sclerosus et atrophicus

SNOMEDCT:
25674000 – Lichen sclerosus et atrophicus

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • 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

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:05/07/2019
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Lichen sclerosus in Infant/Neonate
See also in: External and Internal Eye,Anogenital
Lichen sclerosus : Eyelids, Glans of penis, Labia majora, Smooth plaque, White color, Inguinal region, Pruritus, Skin atrophy, Hardened skin
Clinical image of Lichen sclerosus
A shiny white plaque in the intergluteal fold.
Copyright © 2021 VisualDx®. All rights reserved.