Vulvar lichen sclerosus in children misdiagnosed as sexual abuse

Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
E DelmarreM-D Piercecchi-Marti

Abstract

With the frequency of lawsuits for sexual abuse increasing, high-quality care for victims is of utmost importance. Genital examination is difficult to perform, especially on children, but is a key item for diagnosis. A case report is presented herein to illustrate this issue. A sexual assault was suspected on 2.5-year-old female twins. Clinical examination primarily detected vulvar micro-hematoma and hypopigmentation, discreetly sclerosing, as well as atrophic labia and a beginning of lichenification on one of them. The other twin showed an unspecific and erythematous lesion. Elimination of the supposedly dangerous environment and a remote consultation brought out a paradoxical development to the story and confirmed the diagnosis of vulvar lichen sclerosus. Traumatic lesions caused by sexual abuse are uncommon. Coexisting allegations and lesions in the genital area lend support to the hypothesis of sexual abuse. However, genital-anal tropism dermatosis can mimic traumatic injuries. Lichen sclerosus is an example of a differential diagnosis of vulvar traumatic lesions, which is quite often unknown to physicians, including pediatricians. This case report shows that taking the appropriate time in multidisciplinary councils can sug...Continue Reading

References

Aug 31, 2002·Child Abuse & Neglect·Astrid HegerRaphael Bernier
May 25, 2012·Medicine, Science, and the Law·Dinesh P AsatiShreyansh Tiwari

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