Male genital LS occurs most frequently in uncircumcised middle-aged males. Males affected by genital LS most frequently are middle-aged and uncircumcised. It may present in children as well, from young boys to adolescents. Early in its course, penile lichen sclerosus is relatively asymptomatic with only mild visually observed changes of the penis and glans. Physical changes occur over months or years and may include color or textural changes.
Early symptoms are more prevalent in uncircumcised patients.
As the condition progresses, single or multiple discrete erythematous papules or macules progress and coalesce into atrophic ivory, white, or purple-white patches or plaques. Lesions most commonly affect the glans and prepuce. Frenulum, urethral meatus, fossa navicularis, penile shaft, and the perianal areas may become involved. A sclerotic white ring at the tip of the prepuce is diagnostic at this stage. With further disease progression, the glans may become adherent to the prepuce.