Dec 23, 2018 plasma cell balanitis is an inflammatory skin condition affecting the foreskin and penis head of penis. In most, cases, plasma cell balanitis was successfully treated by circumcision. Apr 05, 2017 introduction zoons balanitis, also referred to as balanitis circumscripta plasmacellularis bcp, is an idiopathic, benign inflammatory condition of the glans penis and foreskin most often seen in elderly uncircumcised men. Zoons plasma cell balanitis associated with male genital. Zoons balanitis british association of dermatologists. Balanitis is not usually serious but its important to see a gp to find out whats causing it.
Resultslesions involved prepuce and glans in 17, prepuce only in 10 and in 5 were localised to glans alone or extended to coronal sulcus. An overview of benign and premalignant lesions of the foreskin. Thalidomide in plasma cell balanitis refractory to. Successful management of zoons balanitis with topical mupirocin.
Penile intraepithelial neoplasia pein is the precursor lesion of penile squamous cell carcinoma scc. Zoon balanitis vulvitis is also known as plasma cell balanitis vulvitis plasma cell disorders usually present as persistent, welldefined irritable red patches on the genitals. Objectiveto evaluate the clinicopathological features and response to circumcision in patients with plasma cell balanitis. The patient was treated with pimecrolimus 1% cream, with significant improvement after 6. This is a grossly aggressive and scarring balanitis. European guideline for the management of balanoposthitis. Histopathology with punch biopsy of one of the lesions on the glans showed a strip of infiltrate rich in plasma cells in the papillary dermis, confirming the diagnosis. Though there has been mentioned about different variants such as vegetative, erosive, or multiple lesions variants in the literature, it typically presents as solitary lesion. Zoon described eight cases of chronic balanitis with unique benign appearing histologic findings previously diagnosed as erythroplasia of queyrat. Mar 02, 2021 zoons balanitis successfully treated with photodynamic therapy. The exact followup regime for zb after treatment is still unclear.
Though there has been mentioned about different variants such as vegetative, erosive, or multiple lesions variants in the literature, 4 it typically presents as solitary lesion. Plasma cell balanitis plasma cell balanitis pcb, also known as balanitis circumscripta plasmacellularis, was. Lesions involved prepuce and glans in 17, prepuce only in 10 and in 5 were localised to glans alone or extended to coronal sulcus. Zoon described eight cases of chronic balanitis with unique benign appearing histologic findings previously diagnosed as erythroplasia of queyrat 123. In all cases circumcision was done and histopathology confirmed. It is characterized by one or more indolent well demarcated, glazed, reddish brown patches on the glans penis or prepuce. Plasma cell cheilitis and plasma cell balanitis of zoon too have. Plasma cell balanitis usually takes more indolent course with lesion.
This may be similar to erythroplasia of queyrat, which is premalignant, and biopsy is advisable. Balanitis circumscripta plasmacellularis or zoons balanitis is an idiopathic, benign condition of the genitalia that mostly presents as a solitary, persistent plaque on the glans of primarily uncircumcised, middleaged to older men. When the foreskin is also affected, it is termed balanoposthitis. What is plasma cell balanitis vulvitis plasma cell disorders usually present as persistent, welldefined irritable red patches on the genitals. Dermoscopic features of plasma cell cheilitis and actinic. A plasma cell is a type of white blood cell found in some inflammatory conditions. Successful management of zoons balanitis with topical. Welcome to the updated version of pathology for urologists. Twenty specimens were available for histopathology. Pdf plasmoacanthoma of oral cavity and plasma cell. An epidermal in situ carcinoma of the reserve cell type with circumscribed plump taps but complete basal cell membrane periodic acid schiffs reaction and collagen type iv was observed, associated with a variable dense lichenoid inflammatory infiltrate of the upper dermis fig.
Plasma cell balanitis zoons balanitis american urological. In, jj zoon first recognized balanitis circumscripta plasmacellularis plasma cell balanitis as an idiopathic, rare, benign penile dermatosis. Plasma cell balanitis pcb, also knows as zoon balanitis, is a benign asymptomatic but chronic and erosive inflammatory condition of the glans penis and prepuce that generally affects uncircumcised men in later years. It is called plasma cell gingivitis where the gingiva gums are involved, plasma cell cheilitis, where the lips are involved, and other terms such as plasma cell orifacial. The significance of traumachronic irritation in the pathogenesis of plasma cell.
Two male patients diagnosed with zoons plasma cell balanitis, confirmed by biopsy, were subjected to. Plasma cell balanitis can often be confused clinically with other conditions, such as erythroplasia of queyrat, fixed drug eruption, psoriasis, lichen planus, secondary syphilis, candidiasis andreiters disease. Plasma cell vulvitis is most commonly found on the inside of the vulva at the entrance to the vagina vestibule or introitus. Plasma cell balanitis typically presents as a solitary, smooth, shiny, redorange plaque on the glans and or the prepuce of an uncircumcised, middleaged to older man. Tissue for histopathology was available in 96 patients. Zoons balanitis treated with topical tacrolimus daga so.
Pdf to evaluate the clinicopathological features and response to circumcision in patients with plasma cell balanitis. It is a collection of disparate conditions with similar clinical presentation and varying aetiologies. Zoon plasma cell balanitis is a benign idiopathic inflammatory skin disease of the glans penis, the coronal sulcus, and the inner aspect of prepuce that typically occurs in middleaged or elderly uncircumcised men. Eoq accounts for roughly 10 % of all penile malignancies and may lead to invasive squamous cell carcinoma. Using of dermoscopy as adiagnostic tool can help in differentiating between noninfectious balanitis zoons plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and nonspeci. Another 52yearold male had progressively enlarging, erosive lesion over vermilion border of lower lip for 6months resembling. Zoons balanitis, also known as balanitiscircumscript aplasmacellularis or plasma cell balanitis, is an idio pathic condition characterized by a heavy stromal in flammatory infiltrate composed of mainly plasma cells. Zoons plasma cell balanitis affecting the glans and prepuce. A patient with a biopsyconfirmed diagnosis of bcp who was successfully treated with topical mupirocin ointment is described. Zoons balanitis, also referred to as balanitis circumscripta plasmacellularis bcp, is an idiopathic, benign inflammatory condition of the glans. Plasma cell balanitis usually presents as solitary, shiny, and redorange plaque on the glans or the prepuce in uncircumcised middleaged or older man.
All patients were followed up for a period of 6 months and no recurrences. When the foreskin is also affected, it is termed balanoposthitis balanitis on boys still in diapers must be distinguished from redness caused by ammoniacal dermatitis. Zoons plasma cell balanitis zpb is a chronic inflammatory genital dermatosis, of unknown etiology, described mostly in older uncircumcised men. It is a common condition affecting about 11% of male genitourinary clinic attendees. Here we present the case of a middleaged man with zoon balanitis who was treated with topical corticosteroids and tacrolimus. The lesions resolved completely after intralesional triamcinolone acetonide.
Also known as balanitis circumscripta plasmacellularis, zoon balanitis balanitis. Zoon plazmasejtes balanitis zoons plasma cell balanitis. Plasma cell cheilitis is another idiopathic benign inflammatory condition of lips having similar dense plasma cell infiltrate histologically. After proper cleaning of the genitalia, the patient applied clobetasol ointment twice a day. The foreskin is a common surgical specimen encountered by the practising histopathologist. Herein we report 8 cases of pcb, presenting with a characteristic clinical picture of the disease. Histopathology showed variable features but were consistent with the diagnosis of plasma cell balanitis. Plasma cell balanitis or zoons balanitis is an idiopathic benign condition. It typically occurs in middleaged and elderly uncircumcised men. Histopathology with punch biopsy of one of the lesions on the glans showed a strip of infiltrate rich in plasma cells in the papillary dermis, confirming the diagnosis of zoon. Plasma cell gingivitis is a rare condition, appearing as generalized erythema redness and edema swelling of the attached gingiva, occasionally accompanied by cheilitis lip swelling or glossitis tongue swelling.
Aetiology balanitis is defined as inflammation of the glans penis, often involving the prepuce balanoposthitis. We describe the first case of pcb ever reported in a patient with a previous history of syphilis, and. Balanitis circumscripta plasmacellularis accessed 2 april 2018 terminology also known as balanitis circumscripta plasmacellularis, zoon balanitis. The patient was treated with pimecrolimus 1% cream, with significant improvement after 6 weeks of treatment. Plasma cell balanitis presenting in a patient with a history. Plasma cell balanitis affects the glans of the penis. Zoons plasma cell balanitis associated with male genital lichen sclerosus jeremie delaleu, md,a,b cbenedicte cavelierballoy, md,d martine bagot, md, phd,a, sebastien fouere, md, a,b and jeannoel dauendorffer, md a,b paris, france key words. In zoon balanitis vulvitis, sections show mucosa which may be attenuated or eroded overlying a dense stromal infiltrate. This program was designed to help urology residents and fellows familiarize themselves with the. Therapeutic circumcisions are performed to treat both benign and neoplastic foreskin lesions. This balanitis does not respond to routine topical antifungals.
Case series zoons plasma cell balanitis associated with male genital lichen sclerosus jeremie delaleu, md,a,b cbenedicte cavelierballoy, md,d martine bagot, md, phd,a, sebastien fouere, md, a,b and jeannoel dauendorffer, md a,b paris, france key words. Subjects and method32 uncircumcised men with penile lesions typical of plasma cell balanitis. Plasma cell vulvitis is a rare condition of unknown cause characterized by a thinned epidermis, dilated vessels, extravasated red blood cells, hemosiderin deposition, and a dense dermal infiltrate predominantly consisting of plasma cells. Plasma cell balanitis pcb or balanitis circumscripta plasma cellularis is a benign, idiopathic condition first recognized by zoon in 1952. In all cases circumcision was done and histopathology confirmed the diagnosis of pcb. Balanitis on boys still in diapers must be distinguished from redness caused by ammoniacal dermatitis. Zoons plasma cell balanitis this was first described by zoon in 1952 69 and is a main differential diagnosis with erythoplasia of queyrat. It has also been called balanitis circumscripta plasmacellularis because the patches are well defined, and plasma cell balanitis because many plasma cells a type of white blood cell may be seen when the affected skin is examined under the microscope. Balanitis circumscripta plasmacellularis plasma cell balanitis is an uncommon entity, but it is likely underreported owing to the lack of symptoms and hesitancy to perform a biopsy on the involved region. The usual presenting feature is an asymptomatic patch or plaque of erythema and induration of the lower lip in an elderly person akin to zoons plasma cell balanitis.
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. Plasma cell balanitisvulvitis can look similar to other skin conditions affecting the penis or the vulva. Clinical presentation involves a single, shiny, well defined reddish patch. Differentiation between balanitis and carcinoma in situ using. The first reported case of plasma cell mucositis involving a mucocutaneous junction was plasma cell balanitis described by zoon in 1952 1. Subsequent reports disclosed similar conditions in other mucosal areas, including plasma cell vulvitis, gingivitis, and cheilitis 2. Jan 01, 20 zoon balanitis, or plasma cell balanitis, is a chronic, benign, rare inflammatory disorder that manifests as lesions localized on the glans penis and prepuce. Resultslesions involved prepuce and glans in 17, prepuce only in 10 and in 5 were localised to glans alone or extended to. Haemosiderin pigment could be detected in only three specimens of patients with shorter. Pdf national guideline for the management of balanitis. Inflammatory condition with prominent plasma cells emedicine. To evaluate the clinicopathological features and response to circumcision in patients with plasma cell balanitis. The mucous membranes of the genitals can also be involved by a similar condition, termed plasma cell balanitis or plasma cell vulvitis.
Simultaneous occurrence of balanoposthitis circumscripta. The lesions are well circumscribed and orangered in colour with a characteristic glazed appearance and multiple pinpont redder spotscayenne pepper spots. Balanitis is when the head of the penis is swollen and sore. It is called plasma cell balanitis in men and plasma cell vulvitis in women because of the numerous plasma cells seen on skin biopsy. Patients should be instructed to retract the foreskin regularly and perform gentle cleansing of entire glans, preputial sac, and foreskin. The world health organisation who classifies pein into two subtypes based on the association with human. A disorder first described by zoon in 1952, zoons balanitis or plasma cell balanitis pcb, is an uncommon clinical disorder seen in middle aged uncircumcised men. Lesions involved prepuce and glans in 17, prepuce only in 10 and in 5 were localised to glans alone or extended to. Histopathology of the lesion showed dense infiltrate of plasma cells. Get a printable copy pdf file of the complete article 987k, or click on a page. He was free of symptoms in two months and no remission appeared in one year after the termination of topical glococorticosteroid treatment. An overview of benign and premalignant lesions of the.
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