A Comparative Study Of The Predisposing Factors And Natural History Of Lichen sclerosus ET Atrophicus (LSA) In Children And Adults

Abstract

Lichen sclerosus et atrophicus (LSA) is a chronic inflammatory dermatosis that results in white plaques with epidermal atrophy usually affecting the genital area in both adults and children. The causes of LSA are not clear but possible predisponsing factors include trauma, infection (borrelia, human papilloma virus), autoimmune diseases and local irritation. This study is a retrospective case review of children and adults with LSA attending the department of Dermatology at the Royal Infirmary in Edinburgh, clinical notes for 22 patients were reviewed for age, sex, personal and familial history, symptoms associated diseases and clinical course and treatment. The mean ages at diagnosis of LSA in 9 children (8F: 1M) and 13 adults (13 F) were 7 and 57.5 years respectively. The mean duration of illness was 1.5 year in children and 5.5 year in adults. Itching was the most common symptom in both children and adults. Children also suffered with difficulties in defaecation and in micturation , dribbling, incontinence, constipation and bleeding. Atopy and hypothyroidism were common associated conditions in both the groups. Squamous cell carcinoma of the vulva was confirmed in two adult patients. This study showed the variable symptoms in children, which seemed more severe than in the adult population.