Occlusion, urine and genital lichen sclerosus

Obesity‐related male genital lichen sclerosus

“…It causes both urinary and sexual dysfunction and is a risk factor for cancer of the penis: up to half of invasive penile carcinomas are associated with genital lichen sclerosus (GLSc) on histopathology . A growing body of evidence suggests that MGLSc is due to chronic occluded exposure of a susceptible epithelium to urine . MGLSc is conventionally managed via an individualized combination of medical and surgical treatment.…”

Differential gene hypermethylation in genital lichen sclerosus and cancer: a comparative study

“…These lesions are characterized by the presence of atrophic white plaques, and show histopathological features such as basal cell degeneration, upper dermal oedema, homogenization of collagen, and chronic inflammatory infiltration. Although the exact aetiology of this disease is uncertain, genetic predisposition, Borrelia burgdorferi infection, chronic exposure of susceptible epithelium to urine and autoimmune factors have been implicated in its pathogenesis . The concept that some, if not all, cases of LS might be caused by an infectious agent is longstanding.…”

“…Although the exact aetiology of this disease is uncertain, genetic predisposition, Borrelia burgdorferi infection, chronic exposure of susceptible epithelium to urine and autoimmune factors have been implicated in its pathogenesis. [1][2][3][4][5] The concept that some, if not all, cases of LS might be caused by an infectious agent is longstanding. Borrelia burgdorferi has been incriminated but is unlikely to be responsible.…”

Atopy, the barrier, urine and genital lichen sclerosus

“…hypospadias); later in life LS occurs after genital piercing for jewellery and surgery; it complicates urethostomies and urostomies; it recurs in grafts (especially skin grafts, rarely mucosal grafts); the distribution of LS mirrors occlusional contact with urine so the anatomical distribution of LS differs strikingly between the sexes, with perianal disease commonplace in the female and vanishingly rare in the male; men with LS manifest urinary microincontinence (they dribble) and if examined attentively are found to have anatomically variant naviculomeatal fossae. [2][3][4][5][6][7] In contradistinction, the evidence for autoimmunity is unconvincing. Why just the anogenitalia?…”