Genital Disorders in Children: What Does a Biopsy Bring?

TL;DR

This paper explains when genital biopsies are useful in children, focusing on rare but important conditions like lichen sclerosus and pigmented lesions.

Contribution

The paper clarifies the histopathological features of rarely biopsied pediatric genital conditions and their diagnostic challenges.

Findings

Genital biopsies are performed in less than 1% of pediatric consultations.

Lichen sclerosus is a key condition requiring biopsy due to its long-term progression.

Pigmented lesions and Crohn’s disease are other important biopsy targets in pediatric genital disorders.

Abstract

A genital biopsy is rarely needed in children, as the common conditions usually have clear clinical features. Pigmented lesions and atypical presentations of disease may need expert histological examination. This paper discusses these scenarios, covering diagnostic difficulties and clinico-pathological correlation.

Biopsies are only performed in less than 1% of all consultations dedicated to paediatric genital dermatology. The objectives of this paper are to review and clarify the histopathological features of the conditions most often biopsied: first, lichen sclerosus, which has a peak incidence in childhood and progresses over years; secondly, pigmented lesions, including atypical genital naevi and common naevi in the context of lichen sclerosus, both histologically differential diagnoses of melanoma, which probably does not present in childhood. And finally, Crohn’s disease, which is a cause of vulval oedema or genital ulceration.

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