Plasma Cell Balanitis: Clinicopathologic Study of 112 Cases and Treatment Modalities
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Journal of Cutaneous Maedicine and Surgery
(Impact Factor: 0.94).
01/2006; 10(1):11-5. DOI: 10.2310/7750.2006.00008
Plasma cell balanitis or Zoon's balanitis is an idiopathic benign condition of the genitalia that mostly presents as a solitary, persistent plaque on the glans primarily in uncircumcised, middle-aged to older men.
One hundred twelve patients with a clinical diagnosis of plasma cell balanitis were studied between January 1985 and April 2003.
The age of the patients ranged from 24 to 70 years. The majority of patients had symptoms for more than 12 months. Lesions involved the prepuce and glans in the majority of patients (66; 58.92%), the prepuce only in 26 patients (23.21%), and the glans only in 20 patients (17.85%). Tissue for histopathology was available in 96 patients. Histologically, epidermal edema, a dense upper dermal band of chronic inflammatory cells, including many plasma cells, dilated capillaries, extravasated red blood cells, and hemosiderin deposition, was seen. In most, cases, plasma cell balanitis was successfully treated by circumcision.
This report describes our experience with plasma cell balanitis and reviews its clinical and histopathologic aspects. The treatment modalities are also reviewed, and the importance of circumcision as the treatment of choice is emphasized.
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ABSTRACT: Chronic erythematous lesions of the penis may result from a variety of underlying causes that form a part of differential diagnosis. They are difficult to diagnose only upon clinical examination and may necessitate performing a biopsy to confirm the diagnosis and also identify the coexisting disease. We report a case of erythroplasia of Queyrat (EQ) with Zoon's balanitis and discuss the classification of the lesion through the analysis of overlapping histological features. A middle-aged uncircumcised man presented with two long-standing erythematous prepucial penile lesions unresponsive to antibiotics. Biopsy performed to establish the diagnosis revealed non-invasive severe dysplastic changes in the epithelium that is typical of EQ. Subepithelial histological features were characteristic of Zoon's balanitis. The extent and nature of inflammatory infiltrate in the dermis described in the literature is quite varied in EQ and in the spectrum of non-cicatricial balanoposthitis. The overlap of histological findings could result in the diagnostic dilemma of a coexistent lesion, as described in this case report.
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ABSTRACT: Balanitis set in practice an aetiological and therapeutical problem. The clinical aspect is not specific except for the pustules which evoke a candidiasis. The mycological and bacteriological cultures should be performed in accordance with the clinical context. The biopsy is useful in case of chronic balanitis resistant to the treatment. Irritation and candidal infection are the main causes. Herpes and primary syphilis should be systematically ruled out. The treatment should not be aggressive and must take into account the possible psychological impact.
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