You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease III1 Apr 2010849 ROLE OF TESTOSTERONE IN THE PATHOGENESIS AND TREATMENT OF LICHEN SCLEROSUS Joshua Meeks, Tao Qi, John Cashy, Ximing Yang, and Chris Gonzalez Joshua MeeksJoshua Meeks More articles by this author , Tao QiTao Qi More articles by this author , John CashyJohn Cashy More articles by this author , Ximing YangXiming Yang More articles by this author , and Chris GonzalezChris Gonzalez More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2351AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Lichen sclerosus (LS) is an inflammatory disorder that affects the urethra of men and genital skin of both men and women. Testosterone cream has been used to treat vulvar lichen sclerosus but the role of hormonal deficiency and testosterone application in the treatment of LS remains undescribed. The goal of our study was to determine the frequency of hypogonadism in men with LS and quantify the expression of the androgen receptor in tissue from men with LS. METHODS From the Northwestern University Enterprise Data Warehouse, a database of over 2 million patients cared for at Northwestern University from 1986 to 2009, men with pathologically identified LS were identified. As a control population, a cohort of control men matched 5:1 by both age and race were identified from the men who presented to our urology department for any treatment. A diagnosis of hypogonadism was identified by ICD9 code and medications used to treat hypogonadism were selected from a list of medications prescribed by physicians. Immunohistochemistical analysis was performed on formalin-fixed and paraffin embedded tissue sections of men with LS using standard protocols and immunoreactivity for the androgen receptor (AR) was determined by a urological pathologist. RESULTS A total of 97 men were identified to have biopsy proven LS and this cohort was compared to 485 men without LS as a control population. Of men with LS 3(3%) had a diagnosis of hypogonadism as compared to 62 men (12.8%) in the control population (p=0.006). There were no men with LS receiving testosterone supplementation for hypogonadism as compared to 12 men (2.5%) of the control population (p=0.11). Immunohistochemical analysis of 31 specimens for AR expression was performed to determine if tissues affected by LS could benefit from treatment with testosterone application. Weak (focal) or cytoplasmic expression of the AR was found in 9 (29%) men, while strong nuclear positive expression was identified in only 7 (22%). CONCLUSIONS Men with LS rarely have an associated diagnosis of hypogonadism and none have undergone testosterone supplementation at our institution. Importantly, immunohistochemical analysis of LS affected tissue did not demonstrate androgen receptor expression in the majority of specimens from men with LS. This suggests that local testosterone application would have benefit in only a subset of LS patients. Chicago, IL© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e331 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Meeks More articles by this author Tao Qi More articles by this author John Cashy More articles by this author Ximing Yang More articles by this author Chris Gonzalez More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...