Lichen sclerosus in Child
There is a well-documented association of lichen sclerosus and autoimmune diseases such as alopecia areata, autoimmune thyroiditis, and vitiligo. Some cases are thought to due to infectious etiology including Borrelia spp. and hepatitis C virus.
Lichen sclerosus does not usually resolve with puberty, but it may improve.
An increased risk of genital squamous cell carcinoma (SCC) has been observed in adult male and female patients with chronic untreated genital lichen sclerosus. For girls and women with vulvar lichen sclerosus, the lifetime risk of vulvar SCC is about 5%.
L90.0 – Lichen sclerosus et atrophicus
895454001 – Lichen sclerosus
- 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 (straddle injury) – no atrophy, consistent history
- Scars – firm, smooth, indurated plaques
- 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
- Lichen simplex chronicus
- Cutaneous candidiasis – may have erosions, but no atrophy; erythema and satellite lesions
- Allergic or irritant dermatitis – may have postinflammatory hypopigmentation, pruritus, erythema, and erosions, but no purpura or telangiectasias
- Bullous pemphigoid