Balanitis xerotica obliterans (BXO) is a variant of Lichen sclerosus (LS) of the glans and foreskin. It is characterized by whitish xerotic patches on the glans. This case report includes two such cases that we encountered in children with complaints of difficulty in micturition and dysuria. They were managed surgically by circumcision and meatoplasty. This article also highlights the importance of screening and awareness of BXO in clinical practice and the need to invest time in evaluating modalities like topical corticosteroids and alternate forms of management in BXO.
Celis S, Reed F, Murphy F, Adams S, Gillick J, Abdelhafeez AH, et al. Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series. J Pediatr Urol 2014;10(1):34–39. DOI: 10.1016/j.jpurol.2013.09.027.
Das S, Tunuguntla HS. Balanitis xerotica obliterans: a review. World J Urol 2000;18(6):382–387. DOI: 10.1007/PL00007083.
Bale PM, Lochhead A, Martin HC, Gollow I. Balanitis xerotica obliterans in children. Pediatr Pathol 1987;7(5–6):617–627. DOI: 10.3109/15513818709161425.
Folaranmi SE, Corbett HJ, Losty PD. Does application of topical steroids for lichen sclerosus (balanitis xerotica obliterans) affect the rate of circumcision? A systematic review. Pediatr Surg 2018;53(11):2225–2227.
Chi C-C, Kirtschig G, Baldo M, Lewis F, Wang S-H, Wojnarowska F. Systematic review and meta-analysis of randomized controlled trials on topical interventions for genital lichen sclerosus. J Am Acad Dermatol 2012;67(2):305–312. DOI: 10.1016/j.jaad.2012.02.044.
Clouston D, Hall A, Lawrentschuk N. Penile lichen sclerosus (balanitis xerotica obliterans). BJU Int 2011;108:14–19. DOI: 10.1111/j.1464-410X.2011.10699.x.
Fistarol S, Itin P. Diagnosis and treatment of lichen sclerosus. Am J Clin Dermatol 2013;14(1):27–47. DOI: 10.1007/s40257-012-0006-4.
Kirtschig G. Lichen sclerosus–Presentation, diagnosis and management. Dtsch Arztebl Int 2016;113(19):337–343. DOI: 10.3238/arztebl.2016.0337.
Charlton OA, Smith SD. Balanitis xerotica obliterans: a review of diagnosis and management. Int J Dermatol 2018;58(7):777–781. DOI: 10.1111/ijd.14236.
Green PA, Bethell GS, Wilkinson DJ, Kenny SE, Corbett HJ. Surgical management of genitourinary lichen sclerosus et atrophicus in boys in England: a 10-year review of practices and outcomes. J Pediatr Urol 2019;15(1):45.e41–45.e45. DOI: 10.1016/j.jpurol.2018.02.027.
Ashraf J, Turner A, Subramaniam R. Single-stage urethroplasty with buccal mucosal inlay graft for stricture caused by balanitis xerotica obliterans in boys: Outcomes in the medium term. J Pediatr Urol 2018;14(1):66.e61–66.e65. DOI: 10.1016/j.jpurol.2017.09.015.