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Lichen sclerosus et atrophicus treatment with the 585-nm flashlamp-pumped pulsed dye laser.

To the Editor.— Lichen sclerosus et atrophicus has frequently been reported to occur in children, the most common sites involved being the genital areas in both girls and boys.1Although dermatologists are very familiar with this entity and its occurrence in prepubertal children, lichen sclerosus et atrophicus is often misdiagnosed by other clinicians, typically as sexual abuse,2as evidenced by this case. Symptomatology usually includes pruritus and sometimes pain, but significant bleeding has rarely been described in the literature. Topical fluorinated corticosteroids are prescribed most frequently, as topical testosterone is not indicated in prepubertal girls. This case demonstrates successful use of the 585-nm flashlamp-pumped pulsed dye laser for treating bleeding telangiectases of prepubertal lichen sclerosus et atrophicus. This form of treatment has not previously been reported for this condition. Report of a Case.— A 7-year-old girl presented in December 1990 for treatment of a vulvar "hemangioma." Her parents