Why biopsy is important in adult with balanitis xerotica obliteranes (BXO) or lichen sclerosis foreskin in phimosis (tight foreskin)

There are some association of skin cancer with BXO. In one of the series, incidence of skin cancer is reported 5.8%.  

In other series, incidence of BXO found adjacent to penile skin cancer is 33%. These findings raised a question whether BXO is pre-malignant condition. 

It is important to do biopsy of all BXO or lichen sclerosis foreskin to confirm the diagnosis and to rule out the concomitant skin cancer. Dr. Khan sends all foreskin with BXO for biopsy after the circumcision. 

Circumcision is strongly indicated if your foreskin shows signs and symptoms of BXO or lichen sclerosis which is causing tight foreskin. 

The British Association of Dermatologists has issued a guideline about MALE GENITAL (PENIS) LICHEN SCLEROSUS