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Vulvar lichen sclerosus (VLS) is an inflammatory and scarring dermatosis occurring predominantly in prepubertal and postmenopausal females. Girls typically present with itching, dysuria, and constipation. Diagnosis is often delayed, and physical signs can be misdiagnosed as child abuse. Potent topical corticosteroid therapy is accepted management for VLS at all ages. However, continued treatment of patients in whom remission is not achieved is less standardized. There is little data on long-term management in prepubertal girls.
Investigators in Australia performed a retrospective study of outcomes of long-term treatment. The target outcome was an asymptomatic, normal examination. They studied 46 girls with prepubertal-onset VSL; photographs …