Balanitis xerotica obliterans

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Balanitis xerotica obliterans (BXO) is lichen sclerosus of the foreskin, a fibrotic condition of the foreskin first described by Stühmer[1],[2] in 1928

The aetiology is unclear. It can be considered the male foreskin equivalent of lichen sclerosus et atrophicus.[3] There is a small risk of dysplasia and progression to squamous cell carcinoma.

Contents

Clinical Features

  • Occurs later in life
  • Foreskin is:
    • thickened
    • stenosed
    • depigmented
    • adherent to glans

Histological Features

  • Epidermal atrophy, but orthokeratotic hyperkeratosis
  • Expanded, hyalinised lamina propria
  • Vacuolar basal degeneration
  • Lichenoid band-like chronic inflammatory infiltrate

Treatment

Circumcision

References

  1. Stühmer, A.: Balanitis xerotica obliterans (post-operationem) und ihre Beziehungen zur “Kraurosis glandis et praeputii penis,” Arch f. Dermat. u. Syph. 156:613, 1928.
  2. http://www.cirp.org/library/treatment/BXO/freeman1/
  3. ARCHIVES OF DERMATOLOGY AND SYPHILOLOGY, Volume 49: Page 57-59 http://www.cirp.org/library/treatment/BXO/laymon1/#n2

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