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Italian Journal of Dermatology and Venereology 2022 August;157(4):342-7

DOI: 10.23736/S2784-8671.22.07301-7

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Folliculosebaceous units are a frequent finding in early lichen sclerosus of the foreskin

Clelia MIRACCO 1, Ernesto DE PIANO 2, Crystal MARRUGANTI 3, Gennaro BALDINO 4, Ester SORRENTINO 1, Anastasia BATSIKOSTA 1, Pietro RUBEGNI 2, Rossella ANGOTTI 5, Mario MESSINA 5, Elisa CINOTTI 2

1 Section of Pathological Anatomy, Department of Medicine, Surgery and Neuroscience, University Hospital of Siena, Siena, Italy; 2 Department of Medicine, Surgery and Neuroscience, Dermatosurgery, University Hospital of Siena, Siena, Italy; 3 Department of Medical Biotechnologies, University of Siena, Siena, Italy; 4 Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy; 5 Department of Medicine, Surgery and Neuroscience, Pediatric Surgery, University Hospital of Siena, Siena, Italy



BACKGROUND: Folliculosebaceous units (FSU) has been considered an early target of inflammation in vulvar lichen sclerosus (VLS). This diagnostic clue is not reported in lichen sclerosus (LS) of the foreskin (FLS) that is normally hairless. We evaluated the presence and inflammation of FSU and sebaceous glands (SG) in LS of the foreskin.
METHODS: Histological specimens from therapeutic circumcision were assessed in order to evaluate the frequency and inflammation of FSU and SG in LS.
RESULTS: Ninety-eight cases, grouped into 46 early (group 1) and 52 overt (group 2) FLS were included in the study. SG-FSU were found in 95.7% of group 1, and 65.4% of group 2 cases. Their density was inversely correlated with patient age (P=0.0014). We observed perifollicular inflammation in all cases with visible SG-FSU and frequent FSU abnormalities.
CONCLUSIONS: SG and FSU were frequent in early FLS and decreased in advanced disease and adults. We hypothesize that SG and FSU are involved in the inflammatory process leading to FLS. These data, which need further investigation, could help to better understand the pathogenesis of FLS.


KEY WORDS: Lichen Sclerosus et atrophicus; Genitalia; Foreskin; Sebaceous glands

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