Penile Melanosis Associated with Lichen Sclerosus et Atrophicus: First Description in the Medical Literature

Abstract

We present a 74-year-old male patient with 3-years history of visible discoloration of the glans penis, without subjective complaints. Histopathological examination after incision biopsy revealed a moderate increase in the number of melanocytes in the basal layer with irregular distribution, without melanocytic nests, melanophages in the superficial dermis, and subepidermal sclerosus. No cytologic atypia of melanocytes was detectable. The diagnosis of melanosis of the genitalia in association with lichen sclerosus was made. The importance of the presented cases implicated the unique clinical manifestation of penile melanosis, associated with lichen sclerosus of the penis in one hand, the essential differentiation between malignant melanoma via careful histological examination for diagnosis confirmation in other, in order to optimize the therapeutic behavior.

Benign dermatoses of the male genital areas: A review of the literature

“…Some authors have highlighted a possible relationship between melanosis and hormonal factors, LSA and HPV infection 48 . However, little is known about the potential risk for genital and nongenital melanoma in these patients 49 …”

“…The most frequent location for melanosis in men is the glans penis, followed by the meatus and the shaft of the penis 48 . The disease is characterized by large multifocal and irregular dark hyperpigmented melanocytic macules, irregularly bordered, unequally colored 49 (Figure 6C).…”

“…Follow‐up studies demonstrated minimal clinical change and no malignant transformation. However sometimes clinical‐dermoscopic examination alone cannot differentiate melanosis from melanoma, so a biopsy is required 49 …”

Topographical Evaluation of Penile Lichen Sclerosus Reveals a Lymphocytic Depleted Variant, Preferentially Associated With Neoplasia: A Report of 200 Cases

“…In such cases, immunostaining could help rule out melanoma. [18][19][20] The lymphocyte, like in other lichenoid lesions, is an important part of penile LS. There is a study that suggests the role of the inflammatory infiltrate, as part of an autoimmune disease.…”

Penile Melanotic Macules: A Case Report

“…[6][7][8][9] We have found only a previously reported case of penile melanosis associated with lichen sclerosus. [10] 4. CONCLUSION Penile melanosis is quite common and may mimic malignant melanoma.…”