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Abstract
Thirty-five girls with a diagnosis of genital lichen sclerosus were seen in review.
Follow-up ranged from 1 to 11 1/2 years with almost half of the patients followed
for 5 or more years. Only 5 of 27 girls examined did not have clinical evidence of
genital lichen sclerosus lesions. Of these 5, 2 girls were still intermittently symptomatic,
and another 2 had been followed for only 1 year. When the patient's symptomatology
alone was considered, 9 had unchanged symptoms and 26 had improvement or resolution
of their symptoms. Eleven of the 26 had improvement, 12 had total resolution of symptoms,
and 3 had always been asymptomatic. No relationship between menarche and symptomatic
improvement or resolution of the disease was observed. Of the 22 girls with lichen
sclerosus lesions, 3 had atrophy of the labia minora and clitoral phimosis, and 1
also had marked contracture of the introitus. This review challenges the commonly
held view that prepubertal genital lichen sclerosus is a process that resolves with
time and the advent of puberty or estrogenization. The current philosophy of withholding
topical testosterone, a potentially curative therapy, from all premenarchal girls
should be reevaluated in selected cases.
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Article info
Footnotes
3This paper was presented in part at the Second Annual Meeting of the North American Society for Pediatric and Adolescent Gynecology held in Cleveland, OH, Sept. 1987.
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Copyright
© 1988 Springer-Verlag New York Inc. Published by Elsevier Inc. All rights reserved.
