title: Composition of the inflammatory infiltrate in pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans): a prospective, comparative immunophenotyping study.
abstract: Dermatopathological evaluation of pediatric preputial inflammatory disease rarely allows for specific diagnosis other than pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans, LSA/BXO). A prospective immunopathological study was performed on 20 consecutive, unselected, clinically and histopathologically confirmed LSA/BXO cases to determine the relative presence of T and B lymphocytes. There were seven cases with early stages of disease, eight with florid disease, and five with later stages of disease. Two ritual circumcision specimens and 12 specimens with non-LSA/BXO balanitis, collected during the same period, were used as controls. The infiltrate in LSA/BXO patients was wholly composed of T cells (positive with UCLH-1 antibody) in all cases. B cells (positive with L-26 antibody) were found only focally in small, discreet, easily recognizable (follicular or early follicle-like) aggregates, positioned slightly deeper than the band-like infiltrate of T cells. T cells were inconspicuous in 9 of the 12 control specimens. In the three other controls, T cells were much more obvious and these patients showed clinical features possibly suggestive of LSA/BXO in early, prediagnosable phases of development. We conclude that limited immunophenotyping may be a useful adjunct to diagnosis in pediatric cases in which only limited tissue is available or the disease may be more difficult to classify with confidence.
authors.affiliation: Department of Fetal and Infant Pathology, University of Liverpool, Royal Liverpool Children's Hospital Alder Hey, United Kingdom.
authors.forename: S A
authors.initials: SA
authors.lastname: Hinchliffe
authors.forename: A O
authors.initials: AO
authors.lastname: Ciftci
authors.forename: M M
authors.initials: MM
authors.lastname: Khine
authors.forename: A M
authors.initials: AM
authors.lastname: Rickwood
authors.forename: J
authors.initials: J
authors.lastname: Ashwood
authors.forename: F
authors.initials: F
authors.lastname: McGill
authors.forename: E M
authors.initials: EM
authors.lastname: Clapham
authors.forename: D
authors.initials: D
authors.lastname: van Velzen
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000473:pathology; D001446:Balanitis / Q000276:immunology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008297:Male; D010409:Penile Diseases / Q000276:immunology* / Q000473:pathology*; D011446:Prospective Studies; D012594:Scleroderma, Localized / Q000276:immunology* / Q000473:pathology*; D013601:T-Lymphocytes / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents