Paediatric lichen sclerosus et atrophicus: A retrospective analysis of 38 paediatric patients

Int J Clin Pract. 2021 Oct;75(10):e14661. doi: 10.1111/ijcp.14661. Epub 2021 Aug 4.

Abstract

Background: Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory cutaneous disease.

Aim: To evaluate the characteristics of paediatric LSA patients in Turkey.

Material and methods: Data for patients aged <18 years who were diagnosed with LSA by a paediatric dermatologist were retrospectively reviewed. Patient demographic characteristics, clinical features, disease duration, the vitamin D level, accompanying diseases, presence of atopy, therapeutic approach and treatment response were recorded.

Results: The study included 38 patients, of whom 35 (92.1%) were female and 3 (7.9%) were male. Mean age at onset of disease was 6.4 ± 3.3 years in females versus 3.1 ± 2.6 years in males. Mean diagnostic delay was 20.6 ± 28.9 months in females and 2 ± 1.7 months in males. In 28 (80%) patients the time from onset of lesions to diagnosis was ≥3 months. The majority (76.3%) of the patients were asymptomatic, whereas five had itching, two had itching and burning, and two had pain. Among the females, 12 (34.3%) and 23 (65.7%) presented with isolated extragenital and anogenital involvement + extragenital lesions, respectively. All three males had isolated extragenital involvement. The most commonly recommended treatments were topical calcineurin inhibitors and calcipotriol/betamethasone ointment. Accompanying diseases were as follows: alopecia areata (n = 2); atopic dermatitis (n = 2); vitiligo (n = 2); ulcerative colitis and juvenile idiopathic arthritis (n = 1); Hashimoto's thyroiditis (n = 1). Among the 28 patients whose vitamin D level was measured, 24 (85.7%) had vitamin D deficiency.

Conclusion: LSA can be asymptomatic in the majority of affected children. Diagnostic delay was noted in 80% of the study's LSA patients, highlighting the lack of awareness of the condition among parents and clinicians.

MeSH terms

  • Alopecia Areata*
  • Child
  • Delayed Diagnosis
  • Female
  • Humans
  • Lichen Sclerosus et Atrophicus* / diagnosis
  • Lichen Sclerosus et Atrophicus* / drug therapy
  • Lichen Sclerosus et Atrophicus* / epidemiology
  • Male
  • Ointments
  • Retrospective Studies

Substances

  • Ointments