Penile lichen sclerosus after allogeneic stem cell transplantation

Area of Science:

• Dermatology
• Hematology
• Oncology

Background:

• Allogeneic stem cell transplantation (SCT) can lead to graft-versus-host disease (GVHD).
• Chronic GVHD commonly affects the skin, gut, liver, and lungs.
• Sclerodermatous chronic GVHD shares histological features with other fibrotic skin conditions.

Observation:

• Three SCT recipients with chronic GVHD developed severe posthitis and phimosis.
• Surgical excision of affected prepuces revealed histological features of lichen sclerosus.
• Key findings included epidermal atrophy and subepidermal fibrotic changes with inflammation.

Findings:

• The histological features of chronic GVHD in these cases were indistinguishable from lichen sclerosus.
• Penile lichen sclerosus presented as a manifestation of late-stage cutaneous GVHD.
• These observations support the inclusion of penile lichen sclerosus within the GVHD spectrum.

Implications:

• This study expands the understanding of the clinical and histological spectrum of chronic GVHD.
• Recognizing penile lichen sclerosus in SCT recipients is crucial for timely diagnosis and management.
• Further research into the pathogenesis and treatment of GVHD-associated fibrotic conditions is warranted.