Outcomes of topically applied glucocorticosteroid adjuvant therapy in patients with lichen sclerosus following circumcision

Introduction. Lichen sclerosus (LS) is one of the common aetiological factors underlying phimosis. However, this cause frequently remains unrecognised in routine clinical practice. Clear, evidence‑based algorithms for the management of phimosis complicated by LS are currently lacking or fail to achieve satisfactory effectiveness.

Objective. To evaluate the efficacy and safety of topical glucocorticosteroid (GCS) therapy after circumcision in men with histologically confirmed LS.

Materials & methods. This prospective randomised study included 132 adult men who underwent circumcision for phimosis between 2023 and 2025. Following histopathological assessment of the preputial specimens, we performed a comparative analysis of patients with and without LS. The severity of genital skin involvement, including histological parameters, as well as selected somatic comorbidities and clinical indices, was assessed. LS-patients were randomised into two groups: group A (study group) comprised 13 patients who received postoperative topical clobetasol propionate 0.05% under regular specialist follow‑up, whereas group B (control group) included 14 patients who were followed up without topical GCS therapy.

Results. LS was identified as the aetiological factor of phimosis in 20.45% (27/132) of cases. The effectiveness of the combined approach in the study group reached 100%, while in the control group the corresponding rate was 78.4%. Conclusion. LS is diagnosed in approximately one in five patients undergoing circumcision for phimosis. In the presence of LS affecting the prepuce and glans penis, a combined strategy consisting of circumcision followed by adjuvant topical GCS therapy appears to be a curative option for this patient population.

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