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Peter J. Koblenzer, MD
St Christopher's Hospital for Children Philadelphia, Pa

JAMA. 1989;261(24):3547-3548.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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 . . . [Full Text PDF of this Article]

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