Images (17)
Lichen sclerosus of the penisN48.0
Synonym(s)
HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Clinical featuresThis section has been translated automatically.
Glans penis: Areal or small-spotted, parchment-like, porcelain-white, dermal, sclerotic foci with atrophic, usually shiny surface. Hemorrhages into the affected areas common. Intially little discomfort, itching possible. Later, feeling of tension, painfulness. Risk of bacterial or mycotic infections. If the urethra is affected, there is a risk of stenosis.
If the prepuce is affected, whitish, sclerotic thickening with increasing annular shrinkage and phimosis. Thereby danger of tearing when pulling back the constricted foreskin especially during sexual intercourse. This constellation leads to a further tendency of sclerosis up to a non-reducible phimosis. There is a risk of the development of squamous cell carcinoma (see figure).
Notice. Long-term persistent, extensive hemorrhages in the area of the glans penis are suspicious for lichen sclerosus et atrophicus!
External therapyThis section has been translated automatically.
See detailed explanations under Lichen sclerosus.
Interval therapy with class II glucocorticoid externa(Kirtschig G et al. 2015).
Alternative: Calcineurin inhibitors (Tacrolimus, Pimecrolimus)
Otherwise consistent caring hydrophobic ointments (e.g. ointments containing paraffin)
Operative therapieThis section has been translated automatically.
Circumcision. This is the therapy of the 1st choice in case of clear progression of the lichen sclerosus as well as in case of beginning phimosis. In most cases this leads to a standstill of the inflammation symptoms.
Progression/forecastThis section has been translated automatically.
Narrowing of the orificium urethrae possible due to sclerosing processes in the glans area (see Fig.).
Chronic course, rarely development of spinocellular carcinoma.
LiteratureThis section has been translated automatically.
- Das S et al (2000) Balanitis xerotica obliterans--a review. World J Urol 18: 382-387
- Delbanco N (1908) Kraurosis glandis et praeputii penis. Arch Derm Syph 91: 384
- Kirtschig G det al (2015) Evidence-based (S3) guideline on (anogenital) lichen sclerosus.
- J Eur Acad Dermatol Venereol 29:e1-43.
- Kizer WS et al (2003) Balanitis xerotica obliterans: epidemiologic distribution in an equal access health care system. South Med J 96: 9-11
- Ientile R et al. (2018) Anti-Inflammatory and Tissue Regenerative Effects of Topical Treatment with Ozonated Olive Oil/Vitamin E Acetate in Balanitis Xerotica Obliterans. Molecules 23: 645.
- Paolino G et al. (2013) Lichen sclerosus and the risk of malignant progression: a case series of 159 patients. G Ital Dermatol Venereol 148:673-678
- Philippou Pet al. (2013) Genital lichen sclerosus/balanitis xerotica obliterans in men with penile carcinoma: a critical analysis. BJU Int 111:970-976
- Russo T et al (2016) Expression of transglutaminase in foreskin of children with balanitis xerotica obliterans. Int J Mol Sci 17:1551.
- Shelley WB et al (1999) Long-term antibiotic therapy for balanitis xerotica obliterans. J Am Acad Dermatol 40: 69-72.
- Stühmer A (1928) Balanitis xeratica obliterans (post operationem) and its relations to kraurosis glandis et praeputii. Arch Dermatol Syph 156: 613-623