[ ARC forum 2 ]

Dermatologist's views

Written by Paul B. at 18 Sep 2002 23:23:29:

As an answer to: Re: LSA/ BXO - Suggested Cure written by Jason M Fox at 17 Sep 2002 21:45:58:

> But where is the proof that it is an autoimmune disease?

Can't speak to that personally, but I gather that it has all the signs of the other auto-immune diseases including as someone mentions elsewhere in this thread, the strong connection with certain HLA genotypes.

> Hmm ... from what a I read ... BXO may lead to cancer.

Apparently so, from my discussion yesterday with the dermatologist. Which means that it is possibly one of the more common reasons for penile cancer (as it is said that HPV does not explain all cases, but remember that penile cancer is itself very rare) and the reason why cancer is not exclusive to uncircumcised men (since BXO is not exclusive to uncircumcised men).

> Usually after how long on appling steroid does BXO settle down?

Can't say exactly, presumably a process over some weeks.

> What did the Dermatologist tell him to try? Is it the usual stuff like Corticosteroid?

Steroid ointment, such as Diprosone OV, is indeed the preferred treatment.

The discussion was quite interesting. Firstly, it appears in dermatological practice, the term "BXO" is deprecated - they call it Lichen Sclerosis - "on the penis" if that is where it happens to be. Circumcision was not mentioned at all as an option, but the anxiety regarding development of squamous cell cancer is a significant concern of management, dictating continuing review (i.e., year by year once the condition is settled) and presumably, biopsy would be repeated if any spot were to appear suspicious after initial treatment.

> What did his biopsy report say? Is his BXO cause by irritation etc?

I (still) don't have that to hand, but the condition is more a cause than result of irritation.

> Waiting to read your answer.

He was most interested to hear about the idea of using Tacrolimus (Protopic) for this condition. This is a "top end" (it is in this country at least, horrendously expensive) treatment for psoriasis, but he was not aware of the proposed use for Lichen Sclerosis. See my post in answer to "Dee" above.


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