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


YALICI ARMAĞAN B., BOSTAN E., AKDOĞAN N., ERSOY EVANS S.

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 2021 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2021
  • Doi Number: 10.1111/ijcp.14661
  • Journal Name: INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
  • Journal Indexes: Science Citation Index Expanded, Scopus, CAB Abstracts, CINAHL, EMBASE, International Pharmaceutical Abstracts, MEDLINE

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.