Comorbidities in Male Patients With Lichen Sclerosus: A Case-Control Study

Abstract

Objective Lichen sclerosus (LS) is a chronic inflammatory skin disease. In male patients, it usually involves the glans penis and foreskin and can cause phimosis or meatal stenosis. The aim of this cross-sectional case-control study was to identify clinically important comorbidities in male patients with LS. Materials and Methods By searching Turku University Hospital electronic health records, the authors identified 630 male patients diagnosed with LS between 2004 and 2020. To investigate possible comorbidities, the authors compared this patient group to a 10-fold larger control group. Results The incidence of LS increased during the study period, from 5 to 27.5 per 100,000 men. Patients were most often diagnosed at 21 to 25 years of age. Patients with LS exhibited markedly increased risks of penile carcinoma (odds ratio [OR], 81.0; 95% CI = 10.82–3516.7; p < .001) and carcinoma in situ of the penis (OR = 60.5; 95% CI = 7.32–2738.9; p < .001). Patients also more commonly exhibited lichen planus (OR = 16.8; 95% CI = 8.97–32.39; p < .001), psoriasis (OR = 3.3; 95% CI = 1.80–5.70; p = .004), angina pectoris (OR = 1.8; 95% CI = 1.10–2.81; p = .013), obesity (OR = 2.6; 95% CI = 1.72–3.77; p < .001), type 2 diabetes (OR = 2.3; 95% CI = 1.74–3.09; p < .001), and hypertension (OR = 1.9; 95% CI = 1.53–2.37; p < .001). The most commonly performed urological procedures were operation for phimosis, uroflowmetry, and ultrasound measurement of residual urine. Conclusions Genital malignancies, other dermatological conditions, and diseases related to metabolic syndrome should be considered when treating patients with LS.