{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T20:17:08Z","timestamp":1785269828797,"version":"3.55.0"},"reference-count":51,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Lichen sclerosus (LS), or balanitis xerotica obliterans as it was previously known, is a chronic inflammatory lymphocyte-mediated scarring dermatosis that often affects the preputial skin and glans, leading to phimosis and urethral strictures if left untreated. We present a narrative review of the literature assessing its aetiology and pathogenesis and discuss its links to penile cancer and its medical and surgical management. Possible hypotheses for the development of LS include chronic exposure to trapped urine, leading to changes in the epithelial structure. This is supported by the fact that circumcision is often curative in the early stages of the disease. Although circumcision can be curative, the use of topical steroids is typically the first-line treatment and may preserve the foreskin and forgo the need for circumcision altogether. Patients should be made aware of a possible association with penile cancer. Although the majority of cases can be treated by medical therapy and circumcision, a significant number of patients may also require penile reconstructive procedures.<\/ns4:p>","DOI":"10.12688\/f1000research.21529.1","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T14:47:23Z","timestamp":1589554043000},"page":"369","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Recent advances in understanding and managing Lichen Sclerosus"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1499-8655","authenticated-orcid":false,"given":"Rachel","family":"Kwok","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taimur T.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suks","family":"Minhas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"337-43","DOI":"10.3238\/arztebl.2016.0337","article-title":"Lichen Sclerosus-Presentation, Diagnosis and Management.","volume":"113","author":"G Kirtschig","year":"2016","journal-title":"Dtsch Arztebl Int."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"839-53","DOI":"10.1111\/bjd.16241","article-title":"British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018.","volume":"178","author":"F Lewis","year":"2018","journal-title":"Br J Dermatol."},{"key":"ref-3","first-page":"49-54","article-title":"Pediatric Lichen Sclerosus: A Review of the Literature and Management Recommendations.","volume":"9","author":"H Dinh","year":"2016","journal-title":"J Clin Aesthet Dermatol."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"111-7","DOI":"10.4103\/0019-5154.152501","article-title":"Male genital lichen sclerosus.","volume":"60","author":"C Bunker","year":"2015","journal-title":"Indian J Dermatol."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"1031-4","DOI":"10.1111\/j.1468-3083.2010.03572.x","article-title":"The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study.","volume":"24","author":"V Sherman","year":"2010","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"61-5","DOI":"10.1007\/978-3-319-99750-6_19","article-title":"Lichen Sclerosus","author":"A Hall","year":"2019"},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"618-27","DOI":"10.21037\/tau.2018.05.06","article-title":"Evaluation and management of adult acquired buried penis.","volume":"7","author":"T Ho","year":"2018","journal-title":"Transl Androl Urol."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"e97-e98","DOI":"10.1111\/jdv.13816","article-title":"EDF lichen sclerosus guideline.","volume":"31","author":"C Bunker","year":"2017","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"127-8","DOI":"10.1111\/ced.14023","article-title":"Male genital lichen sclerosus and filaggrin.","volume":"45","author":"T Shim","year":"2020","journal-title":"Clin Exp Dermatol."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"e104-e105","DOI":"10.1111\/jdv.13821","article-title":"Response to Letter by Prof. C.B.B. 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