PSD03 Does the incidence of male genital dermatoses vary with age?

Abstract Male genital dermatoses are thought to vary with age. While premalignant and malignant lesions are known to be more common in older men, data are lacking for most male genital dermatoses, particularly inflammatory conditions. This study examined the ages of presentation of a range of genital skin problems with the aim of determining whether age and specific male genital skin diseases are related. A retrospective analysis of 852 consecutive patients was performed at a single consultant-led UK specialist clinic dedicated to nonvenereal male genital dermatological conditions. Patients were stratified by age groups spanning from < 10 years to > 90 years. Statistical analysis included χ2-tests to evaluate disease distribution patterns and treatment outcomes across age groups. Inflammatory conditions predominated in younger adults, with lichen planus showing a higher prevalence in patients aged < 40 years compared with those ≥ 60 years (10.0% vs. 1.4%, P < 0.001). Similarly, psoriasis demonstrated higher prevalence in younger adults (7.7% vs. 2.9%, P = 0.018). In contrast, the prevalence of male genital lichen sclerosus increased with age, from 31.6% in patients aged 20–29 years to 49.2% in those aged 60–69 years (P < 0.001). Premalignant conditions showed a significant age-dependent increase, affecting 1.8% of patients aged < 40 years compared with 6.2% of those aged ≥ 60 years (P = 0.006). Uncircumcised status correlated with higher rates of lichen sclerosus (43.9% vs. 28.1%, P < 0.001) and various forms of balanitis (15.9% vs. 3.9%, P < 0.001). Biopsy rates were significantly higher in patients aged ≥ 60 years (22.4% vs. 15.7%, P = 0.03). The need for surgical intervention (including circumcision) increased significantly with age (≥ 60 years: 12.4% vs. < 40 years: 8.3%, P = 0.05), particularly for lichen sclerosus (16.4%) and other forms of balanitis (8.3%). Uncircumcised status (12.1% vs. 4.9%, P < 0.001) and positive smoking history (16.1% vs. 10.6%, P = 0.04) were identified as significant risk factors for surgical intervention. This large single-centre analysis reveals distinct age-related patterns in male genital dermatoses, characterized by a transition from common inflammatory conditions in younger adults to increased prevalence of lichen sclerosus and premalignant conditions with advancing age. Both circumcision and smoking status significantly influence disease distribution and surgical intervention requirements. These findings support the incorporation of age-based risk stratification in clinical decision making and service planning for male genital dermatology services.