Conflict of interest None declared.
Clinical parameters in male genital lichen sclerosus: a case series of 329 patients
Article first published online: 27 JUN 2011
© 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology
Journal of the European Academy of Dermatology and Venereology
Volume 26, Issue 6, pages 730–737, June 2012
How to Cite
Edmonds, E.V.J., Hunt, S., Hawkins, D., Dinneen, M., Francis, N. and Bunker, C.B. (2012), Clinical parameters in male genital lichen sclerosus: a case series of 329 patients. Journal of the European Academy of Dermatology and Venereology, 26: 730–737. doi: 10.1111/j.1468-3083.2011.04155.x
Funding sources Dr Edmonds was a START (Skin Treatment and Research Trust) Clinical Research Fellow also partly salaried by the Joint Research Committee of the Chelsea & Westminster Hospital, Chelsea & Westminster Health Charity and the Westminster Medical School Research Trust.
- Issue published online: 23 MAY 2012
- Article first published online: 27 JUN 2011
- Received: 20 February 2011; Accepted: 31 May 2011
Background The dermatological aspects of male genital lichen sclerosus (MGLSc) have not received much prominence in the literature. Sexual morbidity appears under-appreciated, the role of histology is unclear, the relative places of topical medical treatment and circumcision are not established, the prognosis for sexual function, urinary function and penis cancer is uncertain and the pathogenesis has not been specifically studied although autoimmunity (as in women) and HPV infection have been mooted.
Objective To illuminate the above by analysing the clinical parameters of a large series of patients with MGLSc.
Methods A total of 329 patients with a clinical diagnosis of MGLSc were identified retrospectively from a dermatology-centred multidisciplinary setting. Their clinical and histopathological features and outcomes have been abstracted from the records and analysed by simple descriptive statistics.
Results The collation and analysis of clinical data derived from the largest series of men with MGLSc ever studied from a dermatological perspective has been achieved. These data allow the conclusions below to be drawn.
Conclusions MGLSc is unequivocally a disease of the uncircumcised male; the adult peak is late in the fourth decade; dyspareunia is a common presenting complaint; non-specific histology requires careful interpretation; most men are either cured by topical treatment with ultrapotent steroid (50–60%) or by circumcision (>75%); effective and definitive management appears to abrogate the risk of developing penile squamous cell carcinoma; urinary contact is implicated in the pathogenesis of MGLSc; HPV infection and autoimmunity seem unimportant.