Treatment of balanitis xerotica obliterans with hydrocortisone injections.

Lichen sclerosus et atrophicus was first described by Hallopeau (1887), who regarded it as a variant of lichen planus. Ormsby (1910), however, considered it to be a separate disease entity. Stuhmer (1928) used the term "balanitis xerotica obliterans" to describe a case in which there was progressive sclerosis and atrophy of the glans penis and preputial remains following an operation for congenital phimosis. Balanitis xerotica obliterans was considered to be a localized form of lichen sclerosus et atrophicus by Laymon and Freeman (1944), who described six cases which presented with involvement of the penis. On detailed examination of the rest of the skin they found involvement of the trunk or limbs in four cases. Laymon (1951) described two forms of lichen sclerosus et atrophicus of the male genitalia. In the first group there were isolated papules on the shaft of the penis and prepuce which sometimes coalesced to form a constricting band, and secondly there were cases with white atrophic plaques on the glans and stenosis of the urethral meatus. Lichen sclerosus et atrophicus also occurs on the genitalia id women. This condition has been thoroughly described by Wallace and Whimster (1951). The disease is also well known in female children. Kindler (1953) reported eight cases in girls with anogenital lesions, but only one had lesions elsewhere on the body. The condition has to be distinguished from lichen planus, leucoderma, scleroderma, and leucoplakia. The histological features of lichen sclerosus et atrophicus and balanitis xerotica obliterans are essentially the same. There is slight acanthosis of the epidermis with homogenization of the collagen of the upper corium and a mild round cell infiltration of the lower part of the corium. During the past few years our attention has been drawn to this condition as it affects the male genitalia. It appears to be more common than was formerly supposed and frequently presents in two ways. There may be plaques of white sclerotic tissue on the glans penis or on the prepuce with telangiectases, and, in