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.
Turnbull N, Shim T, Patel N, Mazzon S, Bunker C. Primary Melanoma of the Penis in 3 Patients With Lichen Sclerosus. JAMA Dermatol. 2016;152(2):226-227. doi:10.1001/jamadermatol.2015.3404