Biomedical Journal of Scientific and Technical Research | 2019
Penile Intraepithelial Neoplasia in Association withLichen Sclerosus without Co-Existing Squamous CellCarcinoma is Likely to be of Differentiated andUndifferentiated Types Equally
Abstract
Lichen sclerosus (LS) is a chronic idiopathic skin and mucous membrane disease commonly occurring in the anogenital area of both men and women. The European Association of Urology classifies LS as a premalignant lesion occasionally associated with penile squamous cell carcinoma (SCC) [1]. The prevalence of LS in adult men according to various sources ranges from 0.0014% to 0.3% [2,3]. An important complication of the disease is the development of precancer and invasive carcinoma on its background. At the moment there are few articles in the available literature regarding the malignant potential of the LS of the penis. Almost all of those describe squamous intraepithelial lesion (SIL) associated with penile LS just near the SCC. Based on these observations, the risk of malignant transformation of LS of the penis is 2.3–8.4% [4,5]. There are few available studies investigating the relationship between male genital SL and SIL without a coexisting SCC (Table 1) [5-9]. In most of them, the authors did not set the original goal of studying this association, the latter was an accidental finding [5-7,9]. Kravvas, in their study focused on the features of clinical diagnosis and treatment of patients with male genital LS without SIL and whose having SIL without SCC on the background of this dermatosis [8]. According to published data (Table 1) male LS without co-existing carcinoma is more commonly associated with differentiated penile intraepithelial neoplasia (dPeIN) (7.9%, n=45). Vulvar intraepithelial neoplasia on the background vulvar LS without co-existing carcinoma was found being of both types in 1.2% in equal parts (uVIN 0.6% and dVIN 0.6%) [10,11]. In another study evaluating only LS cases associated with VIN without carcinoma the latter were all of usual type (HSIL) (n=27, 100%) [12]. Table 1: Squamous intraepithelial lesion (usual PeIN and differentiated PeIN) on the background of male genital LS without co-existing squamous cell carcinoma.