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Objective: To call attention to constipation as a frequent sign of lichen sclerosus (LS) in girls., Methods: A focused questionnaire was sent to parents of 24 girls with anogenital LS seen in the pediatric dermatology clinic at the Children's Hospital of Wisconsin between January 2001 and May 2004., Results: Eighteen of 24 questionnaires were completed and returned. The average age of onset of LS was 4.2 years, but average age at diagnosis was 5.2 years; only 1 patient was diagnosed correctly by her primary care physician. Itching was the most common symptom (78%). Severe constipation was reported in 67% of patients, and 89% had at least 1 gastrointestinal complaint (bleeding with bowel movements, fissuring, soiling, fecal impaction, or constipation)., Conclusions: Childhood anogenital LS often presents with recalcitrant constipation or some other gastrointestinal complaint. Primary care physicians need to consider the diagnosis of LS and perform a thorough examination by looking for anogenital lesions when a female pediatric patient presents with unexplained constipation or other severe gastrointestinal complaints.

The antiepileptic hypersensitivity syndrome is a severe, multiorgan reaction to oral antiepileptics that manifests as fever, rash, lymphadenopathy, and hepatitis. This same reaction pattern also has been described following administration of a few unrelated medications. We report on 11 patients who had drug-induced hypersensitivity syndrome and were admitted to our pediatric service and review 94 cases of this syndrome in pediatric patients identified from the literature. We undertook this study to summarize the findings and alert clinicians to the severe internal organ involvement that can occur with this syndrome.

The Gianotti-Crosti syndrome is an infrequently recognized disorder with distinctive characteristics. The eruption, which lasts for two to eight weeks, consists of large, flat-topped, nonpruritic papules on the face, buttocks, and limbs. Its onset may be preceded by fever and upper respiratory tract symptoms. Associated findings include generalized lymphadenopathy, anicteric hepatitis, and HBs antigenemia. Two children with the syndrome are described to bring this entity to the attention of pediatricians.