| Autor: |
Nguyen ATM; South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia., Holland AJA; Douglas Cohen Department of Paediatric Surgery, The University of Sydney School of Medicine, The Children's Hospital at Westmead Clinical School, The Faculty of Medicine and Health, Sydney, New South Wales, Australia. andrew.holland@health.nsw.gov.au. |
| Jazyk: |
angličtina |
| Zdroj: |
European journal of pediatrics [Eur J Pediatr] 2020 Jan; Vol. 179 (1), pp. 9-16. Date of Electronic Publication: 2019 Nov 23. |
| DOI: |
10.1007/s00431-019-03516-3 |
| Abstrakt: |
Lichen sclerosus (LS) is a severe, chronic, dermatosis characterised by inflammatory, sclerotic, pruritic lesions that causes significant morbidity in patients of all genders and ages. In boys, the lesions typically affect the foreskin and glans (termed balanitis xerotica obliterans (BXO)), leading to phimosis and potentially meatal stenosis. The incidence of the disease is not well reported but the average age of affected boys is 8 years (range 1-16). Diagnosis can often be made clinically, although histological study remains important to rule out important differential diagnoses. Complications include genital scarring, urinary and sexual dysfunction as well as the development of carcinomas in adult life. Circumcision has been regarded as definitive management of BXO in boys, but this may be supplemented with medical therapies such as topical steroids, immune modulators, intralesional triamcinolone and ozonated olive oil. Supportive measures including emollients, avoidance of irritants, surveillance of complications and recurrence as well as education and counselling remain important.Conclusion: BXO remains an important cause of phimosis in boys. The frequency of this condition appears unclear but seems likely to be less than 1% of males. Treatment generally involves circumcision, with some evidence that topical steroids or immunomodulators may decrease the incidence of recurrent meatal stenosis.What is Known:• Surgical circumcision is considered the definitive management of BXO• Many aspects of BXO are still in contention or require further study including the epidemiology and aetiology.What is New:• There is increasing awareness of non-surgical modalities that may be used in adjunct to surgery including topical corticosteroids, immune modulators, intralesional triamcinolone and ozonated olive oil• Awareness of meatal stenosis-related BXO has led to the development of surgical techniques such as preputioplasty as well as buccal mucosal inlay grafts. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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