Dermatology case

  • Joana Gaspar Department of Pediatrics, Hospital do Espírito Santo Évora
  • Cristina Tapadinhas Department of Dermatology, Centro Hospitalar Lisboa Norte
Keywords: Paediatrics, sexual abuse, vulvar lichen sclerosus

Abstract

The authors describe the case of a five-year-old girl, observed in Paediatric Dermatology Clinic due to a blood crust and vulvar ecchymosis associated with local pruritus. The observation revealed of a symmetrical and well defined white plaque around the vagina and anus, with mucocutaneous atrophy associated with the absence of labia minora and vascular purpura on the wishbone and clitorial hood. These findings were suggestive of vulvar lichen sclerosus. The aspects present in this entity can be easily confused with sexual abuse, reason why it is important to alert the Paediatricians and General Practice Doctors to the existence and the diagnostic features of this entity.

References

Powell J, Wojnarowska F. Childhood vulvar lichen sclerosus: an increasingly common problem. J Am Acad Dermatol 2001; 44:803-6.

Cooper SM, Arnold SJ. Vulvar lichen sclerosus. UpToDate, accessed in December 2016.

Jensen LS, Bygum A. Childhood lichensclerosus is a rare but important diagnosis. DanMed J 2012; 59:A4424.

Tavares E, Martins C, Teixeira J. Dermatoses Vulvares Inflamatórias. Revista da SPDV. 2011; 69:561-71.

Neill SM, Lewis FM, Tatnall FM, Cox NH; British Association of Dermatologists. British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010. Br J Dermatol. 2010; 163:672-82. doi: 10.1111/j.1365-2133.2010.09997.x.

Bechtek K, Bennett BJ. Evaluation of sexuak abuse in children and adolescents. UpToDate, accessed in December 2016.

Published
2018-07-13
Section
What is your Diagnosis?