RT Journal
A1 Koblenzer PJ
T1 DErmatologic conditions misdiagnosed as evidence of child abuse
JF JAMA
JO JAMA
YR 1989
FD June 23
VO 261
IS 24
SP 3547
OP 3548
DO 10.1001/jama.1989.03420240061012
UL http://dx.doi.org/10.1001/jama.1989.03420240061012
AB To the Editor. — 
    The report by Mss Herman-Giddens and Berson1 documenting traumatic genital care practices in children emphasizes once more the many and varied forms of child abuse. The putative numbers are mind-boggling and the harm done is immeasurable. As physicians, we must strive to the utmost to alleviate this intolerable situation, but scientific objectivity must not be sacrificed.I refer to case 3 in the article by Mss Herman-Giddens and Berson. It is clear that the behavior of the father is inappropriate and potentially harmful to the girl's psychosexual development. Examination of the photograph, however, points to a diagnosis of juvenile lichen sclerosus et atrophicus rather than the steroid effect suggested in the text. Of unknown etiology, evolution of the lesions takes place over a period of years, and resolution might not be complete until puberty. Symptoms that include burning micturition and chronic pruritus are common. I