Balanitis xerotica obliterans: An observational, descriptive and retrospective clinical study

Abstract

Lichen sclerosus is a chronic disease of unknown etiology that can occur in the genital area of both sexes. Balanitis xerotica obliterans (BXO) occurs only in the genital area of men and typically affects the foreskin, penile glans, and/or the meatus. In the present report, an observational, descriptive, and retrospective epidemiological clinical study of available data between January 2006 and December 2020 in patients diagnosed with BXO from the casuistic of CMI DERMAMED (Târgu Mureș, Romania) was performed. During this 15-year period, 164 patients were diagnosed with BXO, of whom 70 (42.8%) were in the 51-60-year-old age group. They presented at the medical consultation at 3-9 months after onset of symptoms, where 124 (75.6%) the patients were found to be with stage III of the disease. The most important comorbidities were found to be diabetes mellitus and obsesity, who were treated with potent steroids (betamethasone and clobetasol) with favorable results, with only nine (5.48%) cases necessitating surgical treatment. In general, BXO is a rare, acquired, non-infectious and chronically inflammatory (autoimmune) skin disease that has an unknown etiology. Although the risk of developing this condition is particularly high in patients in the 40-60-year-old age group, it can occur at any age. In the present report, the majority of the patients presented after a long period of disease development, such that they were already in advanced stages of the condition with clinically subjective symptoms and severe sexual problems. This delay in diagnosis has several causes, including misdiagnosis, psychological issues, and sexual behavior. Diabetes mellitus and overweight/obesity tended to be important comorbidities of BXO since the majority of the patients were also affected by these conditions. These comorbidities can exert an important pathophysiological influence on BXO. The first-line treatment option for this condition is the local application of potent steroids, with favorable effects. Due to the risk of malignant transformation as a result of BXO, it is recommended that these patients should be followed up for a longer period.

Treatment and follow-up of genital lichen sclerosus in male children: multidisciplinary management at a tertiary care center

“… 1 Oldfashioned pseudonyms include balanitis xerotica obliterans and kraurosis vulvae. 2 LS is typically characterized by the presence of hypopigmented atrophic plaques, often accompanied by itching and/or pain. 3 Other possible LS-associated signs include genital discharge, bruises, erosions and scarring.…”

“… 8 LS is classically described as being more frequent in women and having two main peaks of incidence, in prepubertal age and late adulthood. 1 LS was also traditionally considered to be a rare disease ( Supplementary Table 1 ), 2 despite current evidence suggesting such LS prevalence to possibly be underestimated, especially in male subjects and/or children. 9 , 10 The aim of the present paper is to give an insight in the impact of LS on the male pediatric population, through retrospective evaluation of the casuistry collected at a tertiary referral center in the last 10 years.…”

“…These findings suggest surgery to possibly be the first-choice therapeutic option for an inflammatory disorder. 2 , 9 , 10 …”