Cytokine Gene Expression in Male Genital Lichen Sclerosus: Higher IL23A Expression-An Exploratory Study

Background/Objectives: Male genital lichen sclerosus (MGLS) is a chronic inflammatory condition that frequently leads to phimosis and other urological complications. The disease can substantially impair quality of life and is associated with an increased risk of malignant transformation. Although several treatment options are available, the immunological mechanisms underlying MGLS remain incompletely understood. This study investigated the expression of IL22, IL23A, IL12A, IL17A, STAT3, STAT4, and TNF in MGLS tissue. Methods: Tissue samples collected during circumcision from 20 males with histopathologically confirmed MGLS and 17 controls with phimosis but without histopathological evidence of lichen sclerosus were analyzed using real-time quantitative PCR. Results: IL23A expression was significantly increased in the MGLS group (p = 0.0020) and remained significant after Benjamini-Hochberg correction for multiple comparisons (q = 0.0140). Nominal between-group differences in TNF and STAT4 expression were also observed before correction (p = 0.0311 and p = 0.0331, respectively); however, these findings did not remain statistically significant after correction (q = 0.0772 for both). No statistically significant differences were detected for IL17A, IL22, IL12A, or STAT3 expression between groups. Interpretation of the IL17A result was limited by non-detection in a subset of samples and wide confidence intervals. Conclusions: Increased IL23A transcript abundance was observed in MGLS tissue, whereas no statistically significant difference in IL17A expression was detected. However, the IL17A finding should be interpreted cautiously because of limited precision and non-detection in a subset of samples. These findings support further investigation of the biological significance of increased IL23A transcript abundance in MGLS.