In a specialty dermatology clinic, pediatric lichen sclerosus (LS) was difficult to differentiate from vitiligo, especially in patients with medium to dark skin tones, according to a retrospective review of cases.
Researchers who tallied symptoms and physical exam findings observed fewer statistically significant differences between LS and vitiligo patients than expected, and LS and vitiligo were sometimes misdiagnosed as each other.
"LS must be treated aggressively to prevent long-term sequelae such as permanent scarring and vulvar squamous cell carcinoma, making an accurate diagnosis crucial," the authors write in a poster they presented at the annual meeting of the Society for Pediatric Dermatology.
Dr Kaiane Habeshian
LS is symptomatic and has multiple exam findings, but once treated or quiescent, the discoloration can persist and create diagnostic uncertainty, lead study author Kaiane Habeshian, MD, a pediatric dermatologist at Children's National Hospital, Washington, told this news organization following the SPD meeting.
The diagnostic uncertainty is especially true in patients with darker skin tones, who may have vitiligoid LS, an LS variant that has overlapping features of both LS and vitiligo.
Vitiligoid LS "presents clinically as a depigmented symmetric white vulvar and perianal white patch, often with minimal signs of inflammation, but is symptomatic and appears consistent with LS on histopathology," Dr.
