Primary penile melanoma and genital lichen sclerosus

Kate Dear; Georgios Kravvas; Sharmaine Sim; Evanthia Mastoraki; Mariel James; Richard Watchorn; Aiman Haider; Peter Ellery; Alex Freeman; Hussain M Alnajjar; Asif Muneer; Christopher B Bunker

doi:10.1002/ski2.274

Primary penile melanoma and genital lichen sclerosus

Skin Health Dis. 2023 Aug 12;3(6):e274. doi: 10.1002/ski2.274. eCollection 2023 Dec.

Affiliations

¹ Department of Dermatology University College London Hospitals NHS Foundation Trust London UK.
² University College London Medical School London UK.
³ Department of Histopathology University College London Hospitals NHS Foundation Trust London UK.
⁴ Department of Urology University College London Hospitals NHS Foundation Trust London UK.

Abstract

Background: There is a well-established association between squamous cell cancer and genital lichen sclerosus (GLSc). Although there have been several reported cases of vulval melanoma (MM) associated with LSc, particularly in the paediatric population, fewer cases of male genital (M) GLSc and penile (Pe)MM have been published.

Objectives: The aim of this study was to explore further the relationship between PeMM and MGLSc by reviewing all the cases managed by our multidisciplinary service over a finite period.

Methods: All patients known to our tertiary urology and male genital dermatology service with a diagnosis of PeMM and where histology was available for review were identified over an 11-year period (2011-2022). The histology was reviewed by two independent, mutually 'blinded' histopathologists. Photographs and clinical notes, where available, were retrospectively reviewed by two independent dermatologists for signs or symptoms of LSc.

Results: Eleven patients with PeMM were identified for review. Histopathological examination found evidence of LSc in nine patients, and review of clinical photos corroborated the presence of LSc in three. Overall, features of LSc were present in nine out of eleven cases (82%).

Conclusion: The presence of LSc in 9 out of 11 cases of PeMM is suggestive of a causative relationship between LSc and PeMM. This may be due to chronic melanocytic distress created by chronic inflammation secondary to LSc.