Primary Melanoma of the Penis in 3 Patients With Lichen Sclerosus

Turnbull, Nicholas; Shim, Tang Ngee; Patel, Nayna; Mazzon, S.; Bunker, C.B.

doi:10.1001/jamadermatol.2015.3404

Cited by 22 publications

(29 citation statements)

References 7 publications

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“…[ 81 82 83 84 85 ] We have seen three in MGLSc. [ 86 ] It has been postulated that LSc might be an immune response possibly triggered by the melanocytic lesion, alternatively that the inflammatory environment of LSc provides a microenvironmental niche promoting melanocytic neoplasia.…”

Section: Etiologymentioning

confidence: 99%

Male genital lichen sclerosus

Bunker

Shim²

2015

Indian J Dermatol

104

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Male genital lichen sclerosus (MGLSc) is a chronic inflammatory skin disease responsible for male sexual dyspareunia and urological morbidity. An afeared complication is squamous cell carcinoma (SCC) of the penis. The precise etiopathogenesis of MGLSc remains controversial although genetic, autoimmune and infective (such as human papillomavirus (HPV) hepatitis C (HCV), Epstein-Barr virus (EBV) and Borrelia) factors have been implicated: Consideration of all the evidence suggests that chronic exposure of susceptible epithelium to urinary occlusion by the foreskin seems the most likely pathomechanism. The mainstay of treatment is topical ultrapotent corticosteroid therapy. Surgery is indicated for cases unresponsive to topical corticosteroid therapy, phimosis, meatal stenosis, urethral stricture, carcinoma in situ (CIS) and squamous cell carcinoma.

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Section: Etiologymentioning

confidence: 99%

Male genital lichen sclerosus

Bunker

Shim²

2015

Indian J Dermatol

104

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“…SCC is not associated with extragenital LS. Melanoma, basal cell carcinoma and Merkel cell carcinoma have all been reported in patients with vulval LS, and melanoma in male genital LS, but no studies prove that there is an increased frequency of these tumours. There appear to be two pathogenetic mechanisms for genital SCC: firstly, SCC in younger patients is associated with the oncogenic types of human papillomavirus (HPV, specifically high‐risk HPV16 and HPV18); and secondly, in older patients, the association is with a chronic scarring dermatosis such as LS (or LP) with little evidence of a link with HPV .…”

Section: Introductionmentioning

confidence: 99%

British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018

Lewis

Tatnall

Velangi

et al. 2018

British Journal of Dermatology

228

163

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“…In such cases, immunostaining could help rule out melanoma. [18][19][20] The lymphocyte, like in other lichenoid lesions, is an important part of penile LS. There is a study that suggests the role of the inflammatory infiltrate, as part of an autoimmune disease.…”

Section: Discussionmentioning

confidence: 99%

Topographical Evaluation of Penile Lichen Sclerosus Reveals a Lymphocytic Depleted Variant, Preferentially Associated With Neoplasia: A Report of 200 Cases

et al. 2020

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Since the seminal study of Hart and Helwig in 1975, there are few detailed pathological studies of lichen sclerosus (LS). The aims of this study were to provide a detailed histopathological description of penile LS, as well as to explore its relationship with penile intraepithelial neoplasia (PeIN) or invasive carcinoma. We evaluated 200 patients and designed a topographical approach for the histological evaluation focusing in alterations of the following anatomical layers: squamous epithelium, lamina propria, dartos, and corpus spongiosum. We documented the quantity and topographical location of stromal lymphocytes. The prevalent lesions found were epithelial hyperplasia, atrophy, PeIN, basal cell vacuolization, lamina propria sclerosis, and variable patterns of lymphocytic infiltration. Various unique patterns of stromal sclerosis were described: perivascular, globular, linear, and solid fibrosis/hyalinization; any of them were found to be diagnostic for LS. The variation in the topography and density of lymphocytes was determinant for the identification of LS morphological variants: lichenoid, band-like, lymphocytic depleted, and mixed. A major finding was the identification of the variant designated as lymphocytic depleted LS, which we considered as the morphological prototype of LS associated with penile neoplasia. The detailed description of this complex lesion presented in this study may help pathologists in practice to identify and better define LS. The identification of the special variants suggests a role of the stromal lymphocytes in the process of carcinogenesis. Confirmation of the observations with more studies is necessary to determine the significance of these findings.

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Primary Melanoma of the Penis in 3 Patients With Lichen Sclerosus

Abstract: We are also grateful to our colleagues at various health care centers for bringing these patients to our attention and providing knowledge and expertise in the individual cases. These persons were not compensated for their contributions.

Cited by 22 publications

References 7 publications

Male genital lichen sclerosus

Male genital lichen sclerosus

British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018

Topographical Evaluation of Penile Lichen Sclerosus Reveals a Lymphocytic Depleted Variant, Preferentially Associated With Neoplasia: A Report of 200 Cases

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