[Penile malakoplakia associated with lichen sclerosus]

Area of Science:

• Urology
• Pathology
• Dermatology

Background:

• Malakoplakia is a rare granulomatous condition of infectious origin, typically a response to chronic bacterial infections like urinary Escherichia coli.
• It is often associated with impaired phagocytosis, a condition where immune cells cannot effectively clear pathogens.

Observation:

• A 69-year-old male presented with penile malakoplakia, a rare manifestation of the condition.
• The patient had a history of lichen sclerosus and urethral meatal stenosis, leading to recurrent urinary tract infections.
• Initial clinical presentation mimicked squamous cell carcinoma of the glans, but histological examination confirmed malakoplakia.

Findings:

• This case represents one of the few documented instances of penile malakoplakia involving the glans.
• The study suggests a potential link between malakoplakia and lichen sclerosus, possibly mediated by chronic urinary tract infections.
• Factors such as urethral stenosis and local immunodepression from clobetasol use may contribute to this association.

Implications:

• The findings underscore the importance of considering malakoplakia in the differential diagnosis of penile lesions, especially in patients with predisposing conditions.
• Further research is warranted to elucidate the precise mechanisms linking genital lichen sclerosus, chronic urinary tract infections, and malakoplakia development.
• This case contributes to the limited literature on genital malakoplakia, emphasizing its rarity and complex etiology.