Pediatric Vulvar Lichen Sclerosus: A Survey of Disease Course

Kammire, Maria S.; Anderson, Kathryn; Howell, Jennifer O.; McShane, Diana B.; Corley, Sarah B.; Morrell, Dean S.

doi:10.1016/j.jpag.2021.04.010

Cited by 6 publications

(4 citation statements)

References 12 publications

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“… 4 VLS presents a bimodal distribution, occurring in childhood and in postmenopausal women. 5 It was previously believed that pediatric VLS resolves at or after puberty; however, recent evidence has shown that while there may be improvement, true remission cannot be assumed. 4 One study has shown that at least 75% of girls still have ongoing symptoms and signs, 6 suggesting that children with VLS require a correct diagnosis, active management and long‐term follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…VLS is a chronic inflammatory dermatosis of unclear etiology, and its prevalence in the whole population is essentially unknown 4 . VLS presents a bimodal distribution, occurring in childhood and in postmenopausal women 5 . It was previously believed that pediatric VLS resolves at or after puberty; however, recent evidence has shown that while there may be improvement, true remission cannot be assumed 4 .…”

Section: Discussionmentioning

confidence: 99%

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In vivo evaluation of vulvar lichen sclerosus with reflectance confocal microscopy and therapeutic monitoring in children

Chen

Wang

Gao

et al. 2022

Skin Research and Technology

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Background Vulvar lichen sclerosus (VLS) in girls presents with itching, dysuria, and constipation and may result in the loss of vulvar architecture. In patients with an ambiguous clinical presentation, reflectance confocal microscopy (RCM) could be a helpful noninvasive diagnostic tool. The aim of this study was to describe the RCM characteristics of VLS and explore the clinical application value of RCM in therapeutic monitoring. Methods Sixteen patients with VLS were included in the study. All patients were periodically evaluated clinically with RCM, and different treatment regimens were given based on the patient's clinical appearances and RCM features. Results Some major key diagnostic features of VLS can be observed by RCM, including round to oval cyst‐like structures with medium‐to‐low‐refractive keratinoid substances (75%), thinning of the epidermal thickness (100%), destruction of the ring‐like structures around dermal papillae (100%), disorderly distributed coarse medium‐refractive fibrous material (100%),polygonal, plump, high‐refractive cellular structures and linear low‐refractive canalicular structures (100%). All of these characteristics had a high correspondence with histopathological features. The clinical manifestations improved after individualized treatment regimens based on the clinical appearances and RCM features. Conclusion RCM allows the visualization of major key diagnostic features of VLS and represents a valid option for objective therapeutic monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

In vivo evaluation of vulvar lichen sclerosus with reflectance confocal microscopy and therapeutic monitoring in children

Chen

Wang

Gao

et al. 2022

Skin Research and Technology

View full text Add to dashboard Cite

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“…[19][20][21] In their retrospective study, Kammire and colleagues observed a 60% remission rate among young girls with pVLS followed for a mean time of 39 months, although the follow-up duration ranged from 7 months to 6.8 years. 19 Moreover, clinical data were obtained by the means of a telephone interview, without clinical evaluation. In their study, remission was defined as complete absence of symptoms in patients who had previously received first-line treatment and were no longer receiving maintenance treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies on pVLS are limited by cohort size and lack longterm follow-up, limiting our understanding of disease trajectory and long-term sequelae. [19][20][21] In their retrospective study, Kammire and colleagues observed a 60% remission rate among young girls with pVLS followed for a mean time of 39 months, although the follow-up duration ranged from 7 months to 6.8 years. 19 Moreover, clinical data were obtained by the means of a telephone interview, without clinical evaluation.…”

Section: Discussionmentioning

confidence: 99%

Pediatric vulvar lichen sclerosus: Does it resolve or does it persist after menarche?

Boero

Cavalli

Caia

et al. 2023

Pediatric Dermatology

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Background and Objectives Although data regarding the rates of remission and progression of the disease are still scarce, it is generally now acknowledged that pediatric vulvar lichen sclerosus (pVLS) can persist beyond puberty. Recent studies reveal that this condition may persist in as many as 75% of cases. The present study aims to answer the following query: how does pVLS evolve after menarche? Methods This observational retrospective study conducted on premenarchal girls diagnosed with pVLS in our institution between 1990 and 2011 describes 31 patients who returned for multidisciplinary clinical evaluation following menarche. Results The mean follow‐up time was 14 years. At the post‐menarche clinical examination, patients were classified as follows: 58% were still affected by VLS, 16% presented with a complete remission of disease, and 26% were completely asymptomatic although with persistent clinical signs of VLS. Conclusions In our series, pVLS persists following menarche in the majority of patients. These findings suggest the importance of a long‐term follow‐up even among patients who report resolution of symptoms following menarche.

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Miscellaneous Hypomelanoses and Hypochromia

Zhang¹,

Tan²

2023

Atlas of Pigmentary Skin Disorders

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Pediatric Vulvar Lichen Sclerosus: A Survey of Disease Course

Cited by 6 publications

References 12 publications

In vivo evaluation of vulvar lichen sclerosus with reflectance confocal microscopy and therapeutic monitoring in children

In vivo evaluation of vulvar lichen sclerosus with reflectance confocal microscopy and therapeutic monitoring in children

Pediatric vulvar lichen sclerosus: Does it resolve or does it persist after menarche?

Miscellaneous Hypomelanoses and Hypochromia

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