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Evaluating Lichen Sclerosus in Phimosis: Insights From a Multidisciplinary Retrospective Study
Stefano Bighetti1, Stefano Mancon2,3, Nazareno Suardi4
1Dermatology Department, University of Brescia, ASST Spedali Civili di Brescia, Brescia, Italy.
Objectives:
This study aimed to evaluate the prevalence of lichen sclerosus (LS) in male patients undergoing circumcision for phimosis, emphasising the significance of a multidisciplinary approach in the early diagnosis and management of this condition.
Methods:
A retrospective analysis was performed on 841 male patients who underwent circumcision at a high-volume medical centre between 2001 and 2023. Data were collected on clinical diagnoses made by both dermatologists and urologists, along with the corresponding histological findings. Logistic regression models were utilised to assess diagnostic accuracy and the relationship between clinical suspicion and histological confirmation.
Results:
Histological confirmation of LS was identified in 30.6% of the cases. Dermatologists demonstrated a diagnostic accuracy of 81.8%, whereas urologists showed an accuracy of 46.1%. The evaluations conducted by dermatologists exhibited a significant correlation with histological confirmation of LS (odds ratio 4.81; 95% confidence interval: 1.96-11.80; p = 0.001).
Conclusions:
This study elucidates the differences in diagnostic accuracy between dermatologists and urologists in identifying LS in patients undergoing circumcision for phimosis, highlighting the necessity of a multidisciplinary approach to improve the diagnostic process. Furthermore, the epidemiological data obtained from this research offer valuable insights into the prevalence of LS and the associated diagnostic challenges within a substantial patient cohort.
