Kinderchirurgische Praxis, Prinz-Albert-Str. 26, 53113 Bonn, Germany.
Dtsch Arztebl Int. 2011 Jan;108(4):53-8. doi: 10.3238/arztebl.2011.053. Epub 2011 Jan 28.
Lichen sclerosus (LS) is a sclerosing skin disease. When it appears in boys, it nearly always affects the penis and usually causes phimosis requiring surgical treatment. The clinical significance of this disease in boys is inadequately recognized.
The etiology, clinical manifestations, diagnosis, and treatment of LS in boys are presented in the light of a review of selected literature. We also present our own experience with this disease in an ambulatory pediatric surgery practice.
LS has long been recognized as a disease of the prepubertal male genitalia (in such cases, the condition is also called "balanitis xerotica obliterans"). It is thought to be the main cause of acquired phimosis, and it can also involve the meatus and urethra as it progresses. Its possible association with squamous cell carcinoma of the penis remains unclear. Its etiology is unknown; its pathophysiological mechanism involves T-lymphocyte-mediated inflammation. The treatment of choice is complete circumcision. There is still controversy regarding the conservative treatment of LS with topical steroids.
LS is much more common in boys than is generally assumed. Lichen sclerosus should be suspected in any case of acquired phimosis. Treatment with complete circumcision does not necessarily bring about a definitive cure. Further research on the pathogenesis of this disease is needed.
硬化性苔藓（LS）是一种硬化性皮肤病。当它出现在男孩身上时，几乎总是会影响阴茎，并通常导致需要手术治疗的包茎。这种疾病在男孩中的临床意义尚未得到充分认识。
根据对选定文献的回顾，介绍了男孩 LS 的病因、临床表现、诊断和治疗。我们还介绍了我们在门诊小儿外科学实践中对这种疾病的经验。
LS 长期以来被认为是男性生殖器未成熟期的疾病（在这种情况下，该疾病也称为“硬化性苔藓性包茎”）。它被认为是获得性包茎的主要原因，随着疾病的进展，它也可能累及尿道口和尿道。其与阴茎鳞状细胞癌的可能关联仍不清楚。其病因不明；其病理生理机制涉及 T 淋巴细胞介导的炎症。首选的治疗方法是完全包皮环切术。局部皮质类固醇治疗 LS 的保守治疗仍存在争议。
LS 在男孩中比普遍认为的更为常见。任何获得性包茎的情况下都应怀疑 LS。用完全包皮环切术治疗并不一定能根治。需要进一步研究这种疾病的发病机制。
