[Penile malakoplakia associated with lichen sclerosus]

Introduction: Malakoplakia is a granulomatosis of infectious origin in reaction to a chronic bacterial infection (most commonly urinary Escherichiacoli) related to an acquired phagocytosis impairment.

Patients and methods: We report a case of penile malakoplakia in a 69-year-old man with lichen sclerosis and stenosis of the urinary meatus leading to recurrent urinary tract infections. The clinical aspect was suggestive of squamous cell carcinoma of the glans developing on lichen sclerosus, but histological examination revealed penile malakoplakia.

Discussion: Malakoplakia of the genital mucosa is rare, with only one case of involvement of the glans being reported in the literature. The association with lichen sclerosus is probably not fortuitous but could in fact be due to chronic urinary tract infection favored by stenosis of the urethral meatus and possible local immunodepression following prolonged application of clobetasol.

Conclusion: We report a case of penile malakoplakia associated with chronic E. coli urinary tract infection, due originally to associated genital lichen sclerosus.