Balanitis xerotica obliterans and its differential diagnosis.

Background: Balanitis xerotica obliterans is a subcategory of lichen sclerosus et atrophicus limited to the male genitalia and is associated with destructive inflammation, phimosis, urethral stenosis, and squamous cell carcinoma.

Methods: The medical literature was searched from 1983-1998 using key words balanitis, lichen, and sclerosis using the MEDLINE system.

Results And Conclusions: Balanitis xerotica obliterans can be distinguished from other genital dermatoses with similar characteristics through patient history, clinical findings, and laboratory evaluation.. Tzanck smear and cutaneous biopsy, along with a rapid protein reagin test, will provide a definitive diagnosis. Treatment with high-dose topical corticosteroids relieves symptoms, and therapy focuses on prevention of disease progression.