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Development of male genital lichen sclerosus in penile reconstruction skin grafts after cancer surgery: an unreported complication
Author(s) -
Abdelbaky Ather M.,
Aluru Pavan,
Keegan Philip,
Greene Damien R.
Publication year - 2012
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2011.10368.x
Subject(s) - lichen sclerosus , medicine , penile cancer , sex organ , penile carcinoma , verrucous carcinoma , surgery , penis , skin cancer , etiology , incidence (geometry) , stage (stratigraphy) , carcinoma , cancer , dermatology , pathology , physics , biology , optics , genetics , paleontology
Study Type – Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Male genital lichen sclerosis is a disease of unknown aetiology which is believed to be a risk factor for penile cancer. This study reports that the disease can develop in non‐genital skin grafts used for reconstruction following penile cancer surgery. OBJECTIVE • To describe the incidence of the development of male genital lichen sclerosus (LS) in non‐genital skin grafts used in penile reconstruction after cancer surgery. PATIENTS AND METHODS • Between 1997 and 2009, 177 patients received surgical treatment for penile cancer in the Urology Department at Sunderland Royal Hospital, the regional penile cancer centre for the north‐east of England. • Patients who had organ‐sparing surgery and non‐genital penile graft reconstructions were identified. • Histology reports for specimens obtained from those grafts were reviewed to identify the presence of male genital LS and the incidence of recurrence of squamous cell carcinoma (SCC). RESULTS • The mean (range) age of patients at diagnosis was 61.8 (32–89) years. Of the 177 patients, 139 had SCC, 32 had carcinoma in situ and six had verrucous carcinoma. • In total, 56 penile reconstructive procedures were performed using split‐thickness skin grafts obtained from the inner thigh. • From those grafts, 18 specimens were obtained later for cosmetic, diagnostic or curative purposes. • Male genital LS was found in six of the 18 specimens, and one of them was associated with recurrent verrucous carcinoma. CONCLUSIONS • This is the first published series to describe the incidence of male genital LS in penile skin grafts taken from a remote site after penile cancer surgery. • These results represent new information that might help explain the aetiology of male genital LS.