Lichen sclerosus of the penis N48.0

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!

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)

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.

Narrowing of the orificium urethrae possible due to sclerosing processes in the glans area (see Fig.).

Chronic course, rarely development of spinocellular carcinoma.

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