Circumcision Not Recommended
BXO and LSA — Balanitis xerotica obliterans (BXO), also called lichen sclerosus et atrophicus (LSA), is a rare disease. It rarely occurs before age 5, and exists only when there is a unique set of conditions. It is characterized by a thick, white, fibrous band around the prepuce, and by pale gray, parchment-like skin. There is thinning of the epidermis and replacement of the dermis with dense collagenous tissue infiltrated with chronic inflammatory cells. This condition can be progressive. BXO is found more often in circumcised children.1 Traditionally, BXO/LSA has been regarded as an absolute indication for circumcision; however, more recent evidence suggests that treatment with topical corticosteroid ointments is often effective.2
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- Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Brit J Urol 1997;80:776-782. ↩
- Kiss A, Csontai A, Pirot L, Nyirady P, Merksz M, Kiraly L. The response of balanitis xerotica obliterans to local steroid application compared with placebo in children. J Urol. 2001;165(10):219-20. ↩