title: Lichen sclerosus in men is associated with elevated body mass index, diabetes mellitus, coronary artery disease and smoking.
abstract: OBJECTIVE
  To elucidate disease associations and possible etiology of lichen sclerosus (LS), we identified comorbidities present in men with LS. LS is a chronic inflammatory disease of unknown etiology affecting genitals and urethra of men commonly resulting in strictures.
  
  
  METHODS
  Men with LS of the urethra, penis, prepuce and scrotum were identified. A control population was generated from men seen in the Department of Urology matched by age and race in a 5:1 ratio. A case-control study was performed and comorbidities identified by ICD9, CPT codes and medication use via systematic electronic medical record review. Subgroup analysis of men with urethral strictures was performed based on their LS status.
  
  
  RESULTS
  Men with LS had a significantly higher mean body mass index [31.0 (range 18.9-52.6)] compared to controls [28.1 (16.8-64.1), p = 0.001], significantly increased rate of coronary artery disease (CAD) (15.3 vs. 8.9%, p = 0.05) as well as a twofold higher rate of diabetes mellitus (15.5 vs. 8.3%, p = 0.02). Of men with LS and stricture disease, 11/19 (58%) were current or former smokers, compared to 28% of men with strictures without LS (p = 0.006). No association of LS with other morbidities like hyperlipidemia, hypertension, cerebrovascular disease, peripheral vascular disease or dermatologic disorders was found.
  
  
  CONCLUSIONS
  Men suffering from LS have an increased BMI and a higher prevalence of concomitant CAD, diabetes mellitus and tobacco use. Development and chronicity of LS may not be a purely dermatologic condition, but be associated or confounded by systemic or vascular compromise from disorders of CAD, DM and smoking.
authors: Department of Urology, Feinberg School of Medicine, Northwestern University, 675 North St. Clair Street, Galter 20-150, Chicago, IL, 60611, USA.
authors: Matthias D
authors: MD
authors: Hofer
authors: Joshua J
authors: JJ
authors: Meeks
authors: Nitin
authors: N
authors: Mehdiratta
authors: Michael A
authors: MA
authors: Granieri
authors: John
authors: J
authors: Cashy
authors: Chris M
authors: CM
authors: Gonzalez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D018459:Lichen Sclerosus et Atrophicus / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010413:Penis / Q000473:pathology; D015995:Prevalence; D012611:Scrotum / Q000473:pathology; D012907:Smoking / Q000453:epidemiology*; D014521:Urethra / Q000473:pathology
references: Clin Exp Dermatol. 1999 Nov;24(6):479-83
references: 10606954
references: Br J Urol. 1998 May;81(5):735-7
references: 9634051
references: J Eur Acad Dermatol Venereol. 2010 Sep;24(9):1031-4
references: 20202060
references: Br J Dermatol. 1999 Jan;140(1):79-83
references: 10215772
references: Lancet. 2003 Jul 12;362(9378):118-23
references: 12867112
references: J Urol. 2011 Feb;185(2):522-5
references: 21168879
references: Int J Exp Pathol. 2011 Oct;92(5):320-5
references: 21718371
references: Australas J Dermatol. 2004 Feb;45(1):12-5
references: 14961902
references: Aust N Z J Surg. 1994 May;64(5):327-8
references: 8179528
references: AMA J Dis Child. 1956 Jan;91(1):52-4
references: 13275119
references: J Urol. 2007 Dec;178(6):2268-76
references: 17936829
references: Int J Dermatol. 2006 Jun;45(6):681-3
references: 16796627
references: J Am Acad Dermatol. 2011 Jun;64(6):e99-104
references: 21353334