Lichen sclerosus et atrophicus and sexual abuse.
OBJECTIVE
The aetiology of lichen sclerosus et atrophicus (LSA) is unknown. A series of 42 cases of this uncommon condition is reported. The aim of this study was to identify associations of LSA and document the association with sexual abuse.


METHODS
Information about the patients was obtained by retrospective case note review and some patients were contacted by telephone for further information.


RESULTS
In 12 cases there was evidence of sexual abuse. The abused group were slightly older than the non-abused group but were similar in all other respects. All three patients who presented over the age of 12 years had evidence of sexual abuse. Genital trauma was recalled by the patient or found at examination in 17 cases. Evidence of autoimmunity was present in five cases. Positive microbiological isolates were obtained in 18 cases. In only 11 cases were there no associated factors. The symptoms of LSA started between the ages of 3 and 7 years in most patients. The usual symptoms were related to genital skin involvement, and symptoms related to bladder and bowel function were common (50%).


CONCLUSIONS
In this large series of paediatric LSA, associations with trauma, autoimmunity, and infection were noted. There was a high rate of coexisting sexual abuse with LSA, possibly due to genital trauma.
Warrington
S A
SA
Department of Child Health, University of Newcastle upon Tyne, Lindisfarne Centre, Royal Victoria Infirmary.
de San Lazaro
C
C
D000293:Adolescent; D000367:Age Factors; D001327:Autoimmune Diseases / Q000150:complications; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005836:Genitalia, Female / Q000293:injuries; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D012017:Referral and Consultation; D012189:Retrospective Studies