title: Dermatopathology of the foreskin: an institutional experience of over 400 cases.
abstract: BACKGROUND
  Diseases of the foreskin may manifest with an array of pathologic findings, including potentially under-recognized dermatologic conditions. Herein, we summarize an institutional experience in foreskin dermatopathology.
  
  
  METHODS
  Diagnoses rendered on foreskin specimens between 1982 and April 2009 were obtained through a computer-based keyword search. Cases given normal, non-specific or descriptive diagnoses were reviewed by a dermatopathologist.
  
  
  RESULTS
  Keyword search yielded 414 foreskin diagnoses. Interpretations included normal foreskin (n = 131), benign lesions (n = 262) and malignant/dysplastic entities (n = 21). Of 353 cases given normal, descriptive or non-specific diagnoses, 334 were reviewed. Of reviewed cases, 209 (63%) were given more specific diagnoses [e.g. spongiotic dermatitis (n = 115), lichen sclerosus et atrophicus (LSA; n = 41), interface/lichenoid dermatitis (n = 26), psoriasiform dermatitis (n = 7)]. Discrepancy between the clinical and pathologic impression was frequently noted (n = 77).
  
  
  CONCLUSIONS
  This study shows benign inflammatory lesions represent the most frequent foreskin pathology. When possible, specific diagnoses should be rendered, as accurate classification may be of clinical importance. There is an abundance of recent literature on the role of circumcision in disease prevention, and this topic is explored. We discuss the theoretical possibility that foreskin inflammation compromises the mucosal/epithelial barrier, thus playing a role in disease transmission.
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Dava S
authors.initials: DS
authors.lastname: West
authors.forename: John A
authors.initials: JA
authors.lastname: Papalas
authors.forename: Maria A
authors.initials: MA
authors.lastname: Selim
authors.forename: Robin T
authors.initials: RT
authors.lastname: Vollmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male; D003218:Condylomata Acuminata / Q000473:pathology / Q000601:surgery; D016208:Databases, Factual; D003872:Dermatitis / Q000473:pathology* / Q000601:surgery; D052816:Foreskin / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018459:Lichen Sclerosus et Atrophicus / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000601:surgery; D010688:Phimosis / Q000473:pathology / Q000601:surgery; D011565:Psoriasis / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult