Lichen Sclerosus: A Common but Often Overlooked Condition in Pediatric Patients

Lichen sclerosus (LS) is a chronic inflammatory dermatosis that is frequently underdiagnosed in pediatric patients, especially girls presenting with persistent urinary symptoms. We aimed to characterize the clinical features and treatment outcomes in children with LS who presented with urinary symptoms. This retrospective study evaluated 88 children diagnosed with LS at a pediatric nephrology center, all of whom presented with urinary symptoms. Diagnosis was based on clinical and dermatoscopic findings. The mean age at diagnosis was 6.0 years, with a median delay of 8 months. Dysuria (79.5%) and pyuria (87.5%) were the most common symptoms, although only 45.5% had confirmed urinary tract infections. Among 60 patients followed (mean duration = 16.8 months), topical pimecrolimus resolved symptoms in 88.3% and improved skin lesions in 66.6%. Lichen sclerosus should be included in the differential diagnosis for children with urinary symptoms. Clinical awareness and early diagnosis can lead to avoiding unnecessary investigations.