Warrington S A, de San Lazaro C
Department of Child Health, University of Newcastle upon Tyne, Lindisfarne Centre, Royal Victoria Infirmary.
Arch Dis Child. 1996 Dec;75(6):512-6. doi: 10.1136/adc.75.6.512.
The aetiology of lichen sclerosus et atrophicus (LSA) is unknown. A series of 42 cases of this uncommon condition is reported. The aim of this study was to identify associations of LSA and document the association with sexual abuse.
Information about the patients was obtained by retrospective case note review and some patients were contacted by telephone for further information.
In 12 cases there was evidence of sexual abuse. The abused group were slightly older than the non-abused group but were similar in all other respects. All three patients who presented over the age of 12 years had evidence of sexual abuse. Genital trauma was recalled by the patient or found at examination in 17 cases. Evidence of autoimmunity was present in five cases. Positive microbiological isolates were obtained in 18 cases. In only 11 cases were there no associated factors. The symptoms of LSA started between the ages of 3 and 7 years in most patients. The usual symptoms were related to genital skin involvement, and symptoms related to bladder and bowel function were common (50%).
In this large series of paediatric LSA, associations with trauma, autoimmunity, and infection were noted. There was a high rate of coexisting sexual abuse with LSA, possibly due to genital trauma.
硬化性萎缩性苔藓（LSA）的病因尚不清楚。本文报告了42例这种罕见病症。本研究的目的是确定LSA的相关因素，并记录其与性虐待的关联。
通过回顾性病例记录审查获取患者信息，部分患者通过电话联系以获取更多信息。
12例有性虐待证据。受虐组年龄略大于未受虐组，但在其他方面相似。所有3例12岁以上就诊的患者都有性虐待证据。17例患者回忆起生殖器创伤或检查时发现有创伤。5例有自身免疫证据。18例获得阳性微生物分离株。仅11例无相关因素。大多数患者LSA症状始于3至7岁。常见症状与生殖器皮肤受累有关，与膀胱和肠道功能相关的症状也很常见（50%）。
在这一大系列儿童LSA病例中，发现了与创伤、自身免疫和感染的关联。LSA合并性虐待的发生率很高，可能是由于生殖器创伤。
