A 45-year-old man developed pain and itching in the prepucial area 2 months ago associated with difficulty passing urine. He also noticed ballooning of tip of the penis during micturition. In retrospect he complained of mild itching in the same area intermittently for 2 year. Local examination revealed phimosis with patchy leucoplakia of the prepuce. Circumcision resulted in relief of symptoms.Histopathology revealed an atrophic epidermis with basal cell degeneration and focal separation of epidermis from the underlying dermis at dermoepidermal junction. The dermis shows hyaline sclerosis, ectatic capillaries and lymphocytic infiltration. Histological features are typical of lichen sclerosis which is also known as Balanitis xerotica obliterans.
The image shows an atrophic epidermis with hyaline sclerosis of superficial dermis, basal cell vacuolar degeneration, ectatic capillaries and lymphocytic infiltration.