Dermatopathology of the foreskin: an institutional experience of over 400 cases
Article first published online: 25 OCT 2012
Copyright © 2012 John Wiley & Sons A/S
Journal of Cutaneous Pathology
Volume 40, Issue 1, pages 11–18, January 2013
How to Cite
Dermatopathology of the foreskin: an institutional experience of over 400 cases., , , .
- Issue published online: 21 DEC 2012
- Article first published online: 25 OCT 2012
- Accepted manuscript online: 24 SEP 2012 09:05AM EST
- Manuscript Accepted: 6 MAY 2012
Diseases of the foreskin may manifest with an array of pathologic findings, including potentially under-recognized dermatologic conditions. Herein, we summarize an institutional experience in foreskin dermatopathology.
Diagnoses rendered on foreskin specimens between 1982 and April 2009 were obtained through a computer-based keyword search. Cases given normal, non-specific or descriptive diagnoses were reviewed by a dermatopathologist.
Keyword search yielded 414 foreskin diagnoses. Interpretations included normal foreskin (n = 131), benign lesions (n = 262) and malignant/dysplastic entities (n = 21). Of 353 cases given normal, descriptive or non-specific diagnoses, 334 were reviewed. Of reviewed cases, 209 (63%) were given more specific diagnoses [e.g. spongiotic dermatitis (n = 115), lichen sclerosus et atrophicus (LSA; n = 41), interface/lichenoid dermatitis (n = 26), psoriasiform dermatitis (n = 7)]. Discrepancy between the clinical and pathologic impression was frequently noted (n = 77).
This study shows benign inflammatory lesions represent the most frequent foreskin pathology. When possible, specific diagnoses should be rendered, as accurate classification may be of clinical importance. There is an abundance of recent literature on the role of circumcision in disease prevention, and this topic is explored. We discuss the theoretical possibility that foreskin inflammation compromises the mucosal/epithelial barrier, thus playing a role in disease transmission.