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A recurrent rash on the penis

An uncircumcised man in his late 70s presented with a six month history of recurrent asymptomatic patches on his penis. He had experienced three episodes of penile lesions, each lasting for about 7-10 days. On examination, sharply demarcated, glistening, moist, erythematous patches were seen on the glans and opposing inner surface of the foreskin (fig 1). Subtle signs of male genital lichen sclerosus (constrictive posthitis, a preputial inflammation causing a band-like stenosis (sometimes called hourglass penis), and coronal adhesions, inflammatory obliterative fusions located at the mucosal part of the prepuce and corona of the glans penis1 2) were also present (fig 2). No abnormal findings were seen on the penile shaft or scrotum.