Peri-clitoral epidermal inclusion cyst as initial presentation of lichen sclerosus in a pediatric patient.

Document Type

Article

Publication Date

1-24-2024

Publication Title

Journal of pediatric and adolescent gynecology

Keywords

washington; swedish

Abstract

BACKGROUND: Lichen sclerosus (LS) is a chronic inflammatory disorder, presenting with pruritis and hypopigmentation of vulvar and anogenital skin. LS presenting as a peri-clitoral mass has not been previously described.

CASE: A 5-year-old patient with vulvar pruritis and ultrasound showing a homogenous mass was referred for suspected clitoromegaly with normal labs. Exam demonstrated a prepubertal patient with mobile, soft, peri-clitoral mass and surrounding hypopigmentation consistent with LS. The cyst was excised surgically; pathology revealed epidermal inclusion cyst. Post-operatively, she was started on topical steroids for LS with symptom resolution.

CONCLUSIONS: Thorough workup of clitoromegaly negative for hormonal causes requires further investigation to determine alternative etiology of mass. We suspect that inflammatory changes of LS and pruritus resulted in the peri-clitoral inclusion cyst.

Clinical Institute

Women & Children

Department

Pediatrics

Department

Obstetrics & Gynecology

Department

Surgery

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