Pediatric genital lichen sclerosus: a case series of 11 girls

BACKGROUND: Genital lichen sclerosus decreases the quality of life of women; 10-15% of cases occur in prepubertal girls. METHODS: Retrospective and descriptive study on the characteristics of girls diagnosed with genital lichen sclerosus at the Hospital Universitario de Navarra (Pamplona, Spain) between 2019 and 2022. RESULTS: Eleven girls aged between 4 and 14 year-old were diagnosed. Frequently, diagnostic delays were up to two years after the appearance of the lesions; the girl with a four-year delay showed a significant vulvar architectural alteration. All cases showed the typical sclerotic lesions on the genital area, and two of them also on the back. While six patients were asymptomatic, the rest reported pruritus and/or pain. Treatment with high/very high potency topical cortico-steroids achieved a good partial response, without complete remission of the lesions. CONCLUSION: Early diagnosis of genital lichen sclerosus is key to start early treatment, avoiding ireversible genital structural alteration.