Lichen sclerosus in children with phimosis

Aim. Lichen sclerosus, also known as lichen atrophicus, balanitis xerotica obliterans and kraurosis vulvae, is a chronic limphocytes-depending dermatitis predominantly found in the anogenital area of any age group, sex or race. It is most commonly found in Caucasian women: the female to male ratio ranges from 6:1 to 10:1. The real incidence of the disease observed in the literature depends remarkably on the age and sex group studied. The incidence in the pediatric population ranges from 10-15% to nearly 95% if we consider only boys with truly sclerosed and stenotic foreskins. Methods. Our purpose is to evaluate the incidence of lichen sclerosus in a pediatric population with phimosis examinated from January 2001 to December 2004 in the Pediatric Surgery Department of Ferrara. Results. Seventy-nine patients were circumcised: 71 because of a severe phimosis and associated problems such as disuria, urinary obstruction or balanitis and 8 to prevent urinary tract infections in children with vesico-ureteral reflux. Of the patients with severe phimosis 26 (36.6%) showed histologic evidence of lichen sclerosus of the foreskins. In the other group there was no evidence of lichen sclerosus of the prepuce. Conclusion. After the circumcision no recurrence of the disease has been observed.