[Analysis of clinical characteristics in 105 cases of vulvar lichen sclerosus in girls].

This study investigated the clinical features, misdiagnosis patterns, and treatment outcomes of vulvar lichen sclerosus (VLS) in girls through a single-center, observational, retrospective cohort analysis of 105 pediatric patients diagnosed at Beijing Children's Hospital between January 2021 and September 2024. The results showed a mean age of onset of (5.47±2.13) years (median: 5 years) and a misdiagnosis rate of 29.52% (31/105), with vitiligo being the most frequent initial misdiagnosis (20.95%, 22/105). Lesions predominantly presented in a "figure-of-8" pattern involving both the vulva and perianal regions (45.71%, 48/105), with symmetrical hypopigmented or depigmented patches observed in most cases (96.19%, 101/105). Subjective symptoms were reported by 49.52% (52/105) of patients, most commonly pruritus (32.40%, 34/105). Dermoscopy revealed whitish to yellowish structureless areas in all examined cases (100%, 30/30) and purpuric globules in 70% (21/30). Histopathological examination consistently demonstrated the characteristic"sandwich-like"pattern of hyperkeratosis, homogenization of dermal collagen, and band-like lymphocytic infiltration. Regarding treatment, the median time to lesion remission was 4 months for topical calcineurin inhibitor monotherapy and 3 months for combination therapy with a topical corticosteroid, while the median time to symptom relief was 2 months and 3 months, respectively. In conclusion, this study indicates that pediatric VLS in this cohort presented at a relatively early age with a high misdiagnosis rate, typically manifesting as symmetrical hypopigmented patches in a vulvo-perianal distribution. Dermoscopy and histopathology are valuable adjuncts for early diagnosis, and standardized treatment effectively alleviates symptoms.