Lichen Sclerosus — SCE Dermatology MCQ
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Correct answer: A — Circumcision — which is often curative for male genital LS causing phimosis
Circumcision is the definitive treatment for male genital lichen sclerosus (BXO) causing phimosis, and is often curative — removing the affected tissue and eliminating the moist occluded environment that perpetuates the condition. BAD and BASHH guidelines recommend circumcision when topical therapy fails or when there is significant phimosis, recurrent balanitis, or concern about premalignant change. Post-circumcision, any residual LS on the glans should be monitored and treated topically. Long-term surveillance remains important for the approximately 4-8% lifetime SCC risk in genital LS. In women, circumcision is not applicable and management relies on long-term topical corticosteroids with surgical intervention reserved for architectural complications.
Reference: BAD 2018 LS Guidelines; BASHH