LICHEN SCLEROSUS OF PENIS

Abstract

SUMMARY AND CONCLUSIONS enile lichen sclerosus (LS), also known as balanitis xerotica obliterans(BXO) is a chronic inflammatory condition of the penis which can occur at all ages. Penile lichen sclerosus (LS) occurs most commonly on the glans penis and prepuce and less commonly on the scrotum. Perianal involvement is extremely rare in male patients with LS. The etiology of male genital lichen sclerosus is unknown, there is increasing evidence that autoimmune mechanisms play a pathogenetic role, but it is most probably multifactorial as autoimmune factors, genetic factors, trauma, chronic irritation and infections. The exact prevalence of LS is difficult to ascertain and probably underestimated, since patients with LS may present to various clinical specialities, physicians do not always recognize LS and patients may not report symptoms because they are asymptomatic. Both female and male patients are affected and it occurs in children, and in adults. The disease may occur for the first time at any age but in men occur in their fourth decade. The diagnosis of PLS is usually clinical; When the clinical features are typical, histologic examination is not always essential. In clinically inconclusive cases, a histologic P  Summary and Conclusions 77 examination is advisable and might close the gap, but should never be interpreted in isolation. The main differential diagnosis are lichen planus (LP), lichen simplex chronicus, vitiligo, immunobullous disorders such as mucous membrane pemphigoid and vulvar or penile intraepithelial neoplasia. The most common locations for extra genital disease are the buttocks, thighs, breasts, sub-mammary area, neck, back and chest, shoulders, axillae, and wrists. Extra genital LS lesions are prone to koebnerization and may express themselves in areas of physical trauma, continuous pressure, and scarring. Lesions begin as polygonal, bluish white, slightly elevated papules. The treatment of LS could be divided into medical and surgical treatment. Medical treatment of LS involves Topical corticosteroid preparations which are the main stay of medical treatment for LS. Urethral stricture is one of the most common complications of the LS that may cause LUTS and discomfort to the patients. Less invasive procedures like urethral dilatation, internal urethrotomy or urethral stents can afford a good alternative to surgery especially in risky patients.