Disseminated lichen sclerosus in a child: a case report*

Lichen sclerosus (LS) is a benign, chronic, inflammatory dermatosis that mainly affects the genitalia and is characterized by pearly-white papules. Its etiology is still unknown; however, genetic factors and autoimmunity have been implicated. It may occur in all age groups and is more prevalent in females than males, with a ratio of 10: 1. LS shows bimodal distribution with a peak incidence in prepubertal girls and postmenopausal women. It preferably affects the genital area and extra-genital lesions are rare, especially in children. This report describes the case of a female child with an exuberant clinical presentation of LS with genital and disseminated extragenital lesions. A 11-year-old, white, female patient had a 3year history of hypochromic pruritic lesions in the genital area and disseminated hypochromic lesions on the face, trunk, and limbs. Dermatological examination revealed numerous pearly-white papules, some with atrophy, distributed in the frontal region, trunk and limbs, predominating on the dorsal surface of the hands and feet (Figure 1A-C). In some areas, they formed plaques and linear lesions, showing the Koebner phenomenon (Figure 1D). In the genital area, we observed papules and a hypochromic plaque on the labia majora, and erosion and hypochromia on the labia minora and perineum (Figure 2).