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February 2016

Primary Melanoma of the Penis in 3 Patients With Lichen Sclerosus

Author Affiliations
  • 1Waitemata District Health Board, Milford, Auckland, New Zealand
  • 2Chelsea and Westminster Hospital NHS Foundation Trust, London, England
  • 3East and North Hertfordshire NHS Trust, Hertfordshire, England
JAMA Dermatol. 2016;152(2):226-227. doi:10.1001/jamadermatol.2015.3404

Genital lichen sclerosus (GLSc) is associated with squamous cell carcinoma (SCC), although the precise cause is not known. We describe 3 male patients with GLSc and primary penile melanoma. To our knowledge, a possible association between lichen sclerosus and primary penile melanoma has not previously been discussed.

A man in his 50s presented with a firm nodule growing in the left coronal sulcus over 4 months (Figure). Three years earlier, he had been diagnosed with GLSc and unsuccessfully treated with topical steroid preparations of various potencies. Ultimately, he underwent a curative circumcision that same year with histological confirmation of GLSc. Clinically, SCC was suspected, and an excisional biopsy was performed that showed a primary nodular melanoma with a Breslow thickness of 1.2 mm and Clark level 5. Ulceration was seen. Perineural, vascular, and lymphatic invasion were absent. Excision was incomplete, but the patient declined further surgery.

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