Lichen sclerosus clinically manifested in various age group girls

Aim: to study the features of lichen sclerosus (LS) clinically manifested in various age group girls.

Materials and Methods. A prospective observational study with 202 girls aged 0 to 18 years having verified LS clinical and histological diagnosis of LS was conducted. The age of LS onset was examined, determining the time from the appearance of the first symptoms to diagnosis was by analyzing most characteristic disease symptoms such as itching, changes in skin structure and color, the presence of cracks, constipation, dysuria, and lesion area related to childhood age period.

Results. It was found that 30 % LS girls noted the first disease symptoms at the age of 5–6 years (n = 67; 33.1 %). Among patients with vulvar LS, middle childhood (aged 3–5 years) girls predominated (n = 66, 32.7 %). Girls in early childhood (up to 2 years) and puberty period (13–17 years) were in minority comprising as few as 7 (3.5 %) and 19 (9.4 %) cases, respectively. The average LS duration before being properly diagnosed was 2.61 ± 0.13 years. In 27.7 % (n = 56) girls, the disease was asymptomatic, more often in younger patients aged 3–5 years (n = 10). Complaints of itching in the vulva, perineum and perianal area were reported in 58.9 % (n = 119) cases, but only five (2.48 %) girls had itching as a single complaint. In most cases, changes affected all 5 zones – the clitoris, labia minora, the inner surface of the labia majora, perineum and perianal area. A "figure eight"-like LS lesions of the genital tract were observed in 75.2 % (n = 152) girls, more often found in prepubertal (79.8 %; n = 79) and pubertal (82.9 %; n = 29) age.

Conclusion. LS incidence peaks during the transition from middle to late childhood. A more than nine-year observation was shown to shorten average duration of the disease before its diagnosis from 6 to 1.6 years. Analyzing pattern of complaints related to the age of girls allowed to conclude that LS exhibits no specific complaints, except for changes in vulvar skin structure and color, which are noticed only by 5 % patients. Itching in the vast majority of cases (n = 119; 58.9 %) is a consequence of arising complications such as cracks, ecchymosis and erosions.

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