Frequency of lichen sclerosus in children presenting with phimosis: A systematic histological study

Filho, Antonio Merched Aziz; Azevedo, Lucia Maria Soares de; Rochael, Mayra Carrijo; Jesus, Lisieux Eyer de

doi:10.1016/j.jpurol.2022.06.030

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…In fact, LS appears to be relatively common in males in the pediatric population, confirming previous literature possibly being biased by misdiagnosis of the disease. 6 , 9 Moreover, we also observed chronic CS therapy not to be required after circumcision and/or meatal stricture surgical treatment. These findings suggest surgery to possibly be the first-choice therapeutic option for an inflammatory disorder.…”

supporting

confidence: 55%

“… 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. Only male subjects, aged 18 or under, histologically diagnosed with LS between 2013 and 2023 were included.…”

mentioning

confidence: 99%

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

mentioning

confidence: 99%

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

Paganelli¹,

Fabbri

Ghidini

et al. 2023

Dermatol Reports

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confidence: 55%

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confidence: 99%

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

Paganelli¹,

Fabbri

Ghidini

et al. 2023

Dermatol Reports

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“…In a prospective observational study, histologically diagnosed preputial LS was found in 32% of male children with phimosis. Boys with phimosis due to LS were older than those without the disease (mean 8.4 versus 4.7 years old) ( 24 ). In Germany, LS in prepubertal boys was estimated to have a much higher prevalence of up to 0.4% of, as the majority are not commonly circumcised after birth ( 25 ).…”

Section: Epidemiologymentioning

confidence: 99%

Lichen sclerosus: The 2023 update

et al. 2023

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Lichen sclerosus (LS) is an underdiagnosed inflammatory mucocutaneous condition affecting the anogenital areas. Postmenopausal women are predominantly affected and, to a lesser extent, men, prepubertal children, and adolescents. The etiology of LS is still unknown. Hormonal status, frequent trauma and autoimmune diseases are well-known associations for LS, yet infections do not seem to be clear risk factors. LS pathogenesis involves factors such as a genetic predisposition and an immune-mediated Th1-specific IFNγ-induced phenotype. Furthermore, there is a distinct expression of tissue remodeling associated genes as well as microRNAs. Oxidative stress with lipid and DNA peroxidation provides an enabling microenvironment to autoimmunity and carcinogenesis. Circulating IgG autoantibodies against the extracellular matrix protein 1 and hemidesmosome may contribute to the progression of LS or simply represent an epiphenomenon. The typical clinical picture includes chronic whitish atrophic patches along with itching and soreness in the vulvar, perianal and penile regions. In addition to genital scarring, and sexual and urinary dysfunction, LS may also lead to squamous cell carcinoma. Disseminated extragenital LS and oral LS are also reported. The diagnosis is usually clinical; however, a skin biopsy should be performed in case of an unclear clinical picture, treatment failure or suspicion of a neoplasm. The gold-standard therapy is the long-term application of ultrapotent or potent topical corticosteroids and, alternatively, topical calcineurin inhibitors such as pimecrolimus or tacrolimus. Collectively, LS is a common dermatological disease with a so far incompletely understood pathogenesis and only limited treatment options. To foster translational research in LS, we provide here an update on its clinical features, pathogenesis, diagnosis and (emerging) treatment options.

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