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Balanitis xerotica obliterans BXO, also known as lichen sclerosus when it occurs in other parts of the body, is a chronic, inflammatory skin condition that primarily affects the genital area, especially the glans (head) of the penis in men. It can also affect the foreskin, causing scarring and narrowing (phimosis). Lichen sclerosus is more common in males but can also occur in females, often involving the vulva. Key Points About Balanitis Xerotica Obliterans Lichen Sclerosus: Causes and Risk Factors: The exact cause is unknown, but autoimmune factors, genetic predisposition, and environmental triggers such as infections are believed to play a role. It is not sexually transmitted, although it can lead to scarring that complicates sexual function. Symptoms: White, smooth patches on the skin of the genitals (usually on the glans penis or foreskin). Itching, pain, or tenderness in the affected area. Thinning of the skin, which may make it more prone to tearing or injury. Phimosis: the foreskin may become tight and difficult to retract. In more severe cases, the scarring can cause narrowing of the urethra and interfere with urination. Diagnosis: Diagnosis is typically clinical, based on the appearance of the lesions and the patient’s symptoms. Biopsy may be performed in uncertain cases to confirm the diagnosis, as it can show characteristic changes, such as thinning of the epidermis and a sclerotic appearance of the dermis. Complications: If untreated, BXO can lead to significant scarring, phimosis, and functional issues with urination or sexual activity. There is a small but increased risk of developing squamous cell carcinoma a type of skin cancer in areas affected by lichen sclerosus, especially in men with long-standing untreated disease.