The Clinical Spectrum of Lichen Sclerosus in Male Patients – A Retrospective Study

Kantere, Despina; Löwhagen, Gun-Britt; Alvengren, Gunilla; Månesköld, Anna; Gillstedt, Martin; Tunbäck, Petra

doi:10.2340/00015555-1797

Cited by 41 publications

(35 citation statements)

References 27 publications

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“…Several risk factors for penile cancer have been identified, including human papillomavirus (HPV) infection, phimosis and poor hygiene, smoking, chronic inflammation and socioeconomic status . Male circumcision, especially in the neonatal/infant period, has been found to have a protective role in penile cancer, as well as penile inflammation .…”

Section: Introductionmentioning

confidence: 99%

Mutational landscape of penile squamous cell carcinoma in a Chinese population

Wang

Chen

et al. 2019

Intl Journal of Cancer

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Penile squamous cell carcinoma (PSCC) is a malignancy that affects the skin and tissues of the penis, but the knowledge of pathogenesis and carcinogenesis is limited. Here, we characterize the PSCC genomic landscape using whole‐exome sequencing. Of the 30 paired blood and tumor samples, we identified recurrent mutations in 11 genes; confirmed previous findings for FAT1 (4/30), HRAS (4/30), NOTCH1 (4/30), TP53 (3/30) and PIK3CA (3/30); and revealed novel candidate driver genes [CASP8 (4/30), SLITRK2 (3/30), FLG (3/30) and TRRAP (3/30)]. Our in vitro experiments suggested CASP8 was involved in mediating TRAIL‐induced apoptosis of penile cancer cell lines. We also observed the frequently altered pathways for potential therapeutic implications: alterations in the Notch (30% of sample altered), RTK–RAS (26.7% altered) and Hippo (23.3% altered) pathways accounted for over 50% of tumors. The frequently altered genes (>10%) in these pathways were proved to be expressed in penile tumors by immunohistochemistry assay. These findings provide new insight into the mutational and pathway landscapes of PSCC and suggest potential novel therapeutic opportunities for this malignancy.

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Section: Introductionmentioning

confidence: 99%

Mutational landscape of penile squamous cell carcinoma in a Chinese population

Wang

Chen

et al. 2019

Intl Journal of Cancer

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“…[31] Penile cancer was seen in 1% of 771 Swedish men aged 48.6 years (range 22–92) diagnosed with LS during 1997–2007. [71] Another study found penile cancer in 4%–8% of men with LS. [104]…”

Section: Resultsmentioning

confidence: 99%

“…[109] In a Swedish study, 30% of men reported that outcome of local steroid treatment was “good,” while 37% said it was “medium” and 16% “poor” (17% failed to answer). [71] An Indian study of men aged 20–45 years with LS reported a preference by all for circumcision rather than use of steroid creams. [111] In another Indian study, 77% received circumcision for treatment.…”

Section: Resultsmentioning

confidence: 99%

Penile inflammatory skin disorders and the preventive role of circumcision

Morris

Krieger

2017

Int J Prev Med

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Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations. We conducted a systematic review of the medical literature on PubMed, EMBASE, and Cohrane databases using keywords “balanitis,” “posthitis,” “balanoposthitis,” “lichen sclerosus,” “penile inflammation,” and “inflammation penis,” along with “circumcision,” “circumcised,” and “uncircumcised.” Balanitis is the most common inflammatory disease of the penis. The accumulation of yeasts and other microorganisms under the foreskin contributes to inflammation of the surrounding penile tissue. The clinical presentation of inflammatory penile conditions includes itching, tenderness, and pain. Penile inflammation is responsible for significant morbidity, including acquired phimosis, balanoposthitis, and lichen sclerosus. Medical treatment can be challenging and a cost burden to the health system. Reducing prevalence is therefore important. While topical antifungal creams can be used, usually accompanied by advice on hygiene, the definitive treatment is circumcision. Data from meta-analyses showed that circumcised males have a 68% lower prevalence of balanitis than uncircumcised males and that balanitis is accompanied by a 3.8-fold increase in risk of penile cancer. Because of the high prevalence and morbidity of penile inflammation, especially in immunocompromised and diabetic patients, circumcision should be more widely adopted globally and is best performed early in infancy.

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“…This finding is different from the study done by Kantere et al where prepuce along with glans was the most common site of involvement. 5 The close resemblance of LS to vitiligo also warrants proper differentiation both clinically and histopathologically. There were two cases of Balanitis xerotica obliterans (BXO), both presented clinically as thickened, contracted fissured prepuce fixed over the glans leading to phimosis.…”

Section: Discussionmentioning

confidence: 99%

Lichen sclerosus: a clinical study

et al. 2017

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INTRODUCTIONLichen sclerosus (LS) is a chronic inflammatory disorder predominantly involving the anogenital skin and rarely extra genital site. It is more prevalent in females accounting for a 5:1 gender ratio.1 There is bimodal peak of incidence from prepubertal children to postmenopausal group in women and 30-50 years of age in men.2 Aetiology is multifactorial which includes autoimmunity, hormonal factors, infections, local factors, genetic factors. 3Clinical pattern range from asymptomatic to pruritic sclerotic plaques and end stage balanitis xerotica obliterans in men. The objective of this study was to document the clinical, demographic pattern and associated systemic diseases of lichen sclerosus (LSA) in patients attending Skin OPD, RIMS, Imphal. METHODS Inclusion criteriaInclusion criteria was all patients presenting with signs and symptoms consistent with LSA either clinically or histopathologically. ABSTRACTBackground: Lichen sclerosus (LS) is a chronic inflammatory disorder that preferentially affects the anogenital region and rarely extra genital sites. It is more common in women and has a bimodal peak of incidence. The objective of the study was to document the clinical, demographic pattern and associated systemic diseases of lichen sclerosus (LS) among patients attending skin OPD, RIMS, Imphal. Methods: All patients presenting with signs and symptoms suggestive of lichen sclerosus (LS) were studied for a period of 24 months from March 2014 to February 2016. Clinical examination and relevant investigations including histopathology were performed. Results: A total of 54 patients were studied (17 males and 37 females). M:F ratio was 1:2.2. Majority belonged to 25-44 years age group (29.6%). Ano-genital LS comprised 81.4% of the cases. All patients presented with hypopigmented atrophic plaque (100%). The commonest site was prepuce (53.3%) in males and labia majora, labia minora and clitoris (62%) in females. There were 2 cases of balanitis xerotica obliterans (BXO). Ten patients (18.6%) had extragenital LSA and the sites involved were trunk, waist and extremities. Associated systemic diseases were detected in 6 patients. Conclusions: Lichen sclerosus is not an uncommon disease. Varied presentations ranging from asymptomatic white patch to severe inflammation and scarring were noted. Complications especially with genital involvement can be prevented by early diagnosis and adequate treatment. Screening for associated systemic disease may prove useful.

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The Clinical Spectrum of Lichen Sclerosus in Male Patients – A Retrospective Study

Cited by 41 publications

References 27 publications

Mutational landscape of penile squamous cell carcinoma in a Chinese population

Mutational landscape of penile squamous cell carcinoma in a Chinese population

Penile inflammatory skin disorders and the preventive role of circumcision

Lichen sclerosus: a clinical study

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