Clinical Image
Austin J Dermatolog. 2016; 3(4): 1057.
Lichen Sclerosus ET Atrophicus Induced Acquired Phimosis
Tanaka R*, Fujisawa Y, Maruyama H and Fujimoto M
Department of Dermatology, University of Tsukuba, Japan
*Corresponding author: Tanaka R, Department of Dermatology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan
Received: August 19, 2016; Accepted: August 25, 2016; Published: August 26, 2016
Keywords
Phimosis; Atrophicus; Lichen sclerosus
Clinical Image
A 71-year-old, uncircumcised man developed phimosis and decreased penile sensitivity (Figure 1). After observing his hardened foreskin, Lichen Sclerosus ET Atrophicus (LSA) was thought to be the most probable disease, hence circumcision was performed. The foreskin exhibited atrophy and hardening in the central area (Figure 2). Histologically, it showed collagen sclerosis in the dermis and dermal lymphocytic infiltration, and was consequently diagnosed as LSA.
Figure 1: Clinical and histological findings of the circumcised foreskin.
Acquired phimosis had developed owing to tightening of the foreskin of the
penis.
Figure 2: Atrophy and hardening had formed at the inverted part of the
foreskin.
LSA is a chronic inflammatory dermatosis, causing fibrotic and atrophic cutaneous disorder of unknown etiology [1]. Although the incidence of LSA was reported as 32% among acquired phimosis patients [2], it might be underestimated in daily clinics because of lack of recognition. The general principles of management of LSAinduced phimosis are not only to minimize sexual and urinary dysfunction but also to abolish the risk of progression to penile cancer [3]. Therefore, accurate diagnosis and adequate treatment are necessary for those who develop acquired phimosis due to LSA.
Acknowledgement
The authors would like to thank F. Miyamasu (Medical English Communications Center, University of Tsukuba) for grammatical review and advice.
References
- Neill SM, Lewis FM, Tatnall FM, Cox NH. British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010. Br J Dermatol. 2010; 163: 672-682.
- Aynaud O, Piron D, Casanova JM. Incidence of preputial lichen sclerosus in adults: histologic study of circumcision specimens. J Am Acad Dermatol. 1999; 41: 923-926.
- Edmonds EV, Hunt S, Hawkins D, Dinneen M, Francis N, Bunker CB. Clinical parameters in male genital lichen sclerosus: a case series of 329 patients. J Eur Acad Dermatol Venereol. 2012; 26: 730-737.
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