Obesity-related male genital lichen sclerosus.

BACKGROUND: Obesity is increasing. Male genital lichen sclerosus (MGLSc) is almost exclusively a disease of the uncircumcised. An apparent increasing challenge is MGLSc in previously circumcised obese males.

OBJECTIVES: To characterise patients with obesity-related MGLSc.

METHODS: Case chart review of patients managed in specialist clinics.

RESULTS: Nineteen patients with obesity-related MGLSc were identified. All had been previously circumcised. 16 (84%) acknowledged urinary microincontinence ('dribbling'). 14 (74%) remitted with medical treatment and 5 (26%) needed specialised surgery.

CONCLUSIONS: Male genital lichen sclerosus can complicate obesity in previously circumcised patients. Management requires dermatological and specialist urological input, and can be challenging, but effective. The phenomenon increases the evidence for the role of the occlusive influence of urine in the pathogenesis of MGLSc.