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Relhan V, Kumar A, Kaur A. Zoon's Balanitis - Update of Clinical Spectrum and Management. Indian J Dermatol 2024; 69:63-73. [PMID: 38572053 PMCID: PMC10986884 DOI: 10.4103/ijd.ijd_834_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission.
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Affiliation(s)
- Vineet Relhan
- From the Department of Dermatology, Maulana Azad Medical College, New Delhi, India
| | - Abhinav Kumar
- From the Department of Dermatology, Maulana Azad Medical College, New Delhi, India
| | - Aneet Kaur
- From the Department of Dermatology, Maulana Azad Medical College, New Delhi, India
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2
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Bellinato F, Ioris T, Pascucci E, Viola F, Gisondi P, Girolomoni G. Long-term follow-up of Zoon balanitis: a retrospective cohort study. Arch Dermatol Res 2023; 316:44. [PMID: 38103087 DOI: 10.1007/s00403-023-02769-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/17/2023] [Accepted: 10/05/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy.
| | - Tommaso Ioris
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Enrico Pascucci
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Federica Viola
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, 37126, Verona, Italy
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3
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Wierzbicki PM, Czajkowski M, Kotulak-Chrząszcz A, Bukowicz J, Dzieciuch K, Sokołowska-Wojdyło M, Kmieć Z, Matuszewski M. Altered mRNA Expression of NFKB1 and NFKB2 Genes in Penile Lichen Sclerosus, Penile Cancer and Zoon Balanitis. J Clin Med 2022; 11:jcm11247254. [PMID: 36555871 PMCID: PMC9784631 DOI: 10.3390/jcm11247254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The nuclear factor-κB transcription factors 1 and 2 (NFKB1 and NFKB2) are key components of the NF-κB pathway, which responds to inflammatory signals. Since the NFKB1/2 factors are activated via different inflammatory molecules, we aimed to check their expression levels in penile cancer (PC), penile dermatoses: lichen sclerosus (PLS) and zoon balanitis (ZB). METHODS Skin biopsies from altered and healthy looking foreskin were obtained from 59 (49 LS; early PLS: 13, moderate PLS: 32, severe PLS: 4; 6 PC; 4 ZB) and unchanged foreskin from 13 healthy control adult males undergoing circumcision. NFKB1/2 mRNA levels were quantified by qPCR. RESULTS The highest levels of NFKB1 and NFKB2 were observed in PC, ca. 22 and 3.5 times higher than in control, respectively. NFKB1 expression was correlated with PLS progression (rs = 0.667) and was ca. 20 times higher in advanced PLS than in controls and early PLS. Occurrence of micro-incontinence was associated with elevated NFKB1 levels in PLS. CONCLUSION This is the first study regarding gene profiles of NFKB1/2 in PC and penile dermatoses. New drugs targeting modulation of canonical-activated NF-κB pathway should be studied and introduced to the treatment of PLS and PC apart from other treatments.
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Affiliation(s)
- Piotr M. Wierzbicki
- Department of Histology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Mateusz Czajkowski
- Department of Urology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland
- Correspondence:
| | | | - Justyna Bukowicz
- Hematology Laboratory, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland
| | - Klaudia Dzieciuch
- Early Phase Clinical Research Center, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland
| | - Małgorzata Sokołowska-Wojdyło
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Mariana Smoluchowskiego 17 Street, 80-214 Gdansk, Poland
| | - Zbigniew Kmieć
- Department of Histology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Marcin Matuszewski
- Department of Urology, Medical University of Gdańsk, Mariana Smoluchowskiego 17 Street, 80-214 Gdańsk, Poland
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Palma CA, Ferguson P, Jeffery N. Zoon's balanitis presenting as discrete polyp on glans penis. Urol Case Rep 2022; 45:102262. [PMID: 36267343 PMCID: PMC9576557 DOI: 10.1016/j.eucr.2022.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/29/2022] [Accepted: 10/07/2022] [Indexed: 11/28/2022] Open
Abstract
The diagnosis of genital dermatological conditions in males can be challenging and rely on physical examination and biopsy. This report describes an unusual case of Zoon's balanitis producing a discrete polyp on the glans penis, in addition to the classically described well-demarcated erythematous macule.
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Affiliation(s)
- Catalina A. Palma
- Department of Urology, Royal Prince Alfred Hospital, Sydney, Australia,Corresponding author. Department of Urology, Royal Prince Alfred Hospital, 50 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Peter Ferguson
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Nicola Jeffery
- Department of Urology, Royal Prince Alfred Hospital, Sydney, Australia
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Udare S, Patil PD, Chilgar P. Successful management of Zoons balanitis with the combination of pimecrolimus and excimer laser. Indian J Sex Transm Dis AIDS 2022; 43:235-236. [PMID: 36743079 PMCID: PMC9890981 DOI: 10.4103/ijstd.ijstd_59_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/13/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Satish Udare
- Sparkle Skin and Aesthetic Clinic, Navi Mumbai, Maharashtra, India
| | | | - Punam Chilgar
- Sparkle Skin and Aesthetic Clinic, Navi Mumbai, Maharashtra, India
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Jindal R, Chauhan P, Meena D, Chugh R. Dermoscopic characterization of zoon balanitis: First case series from Asia. Indian Dermatol Online J 2022; 13:86-89. [PMID: 35198473 PMCID: PMC8809169 DOI: 10.4103/idoj.idoj_247_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/07/2021] [Accepted: 05/24/2021] [Indexed: 11/26/2022] Open
Abstract
Zoon balanitis is a rare chronic inflammatory dermatosis involving genitalia. It is often misdiagnosed or diagnosed late leading to significant patient distress. Dermoscopy can act as a useful modality in prompt diagnosis of zoon balanitis. Herein, we report dermoscopic findings in twelve lesions of zoon balanitis in seven patients.
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Nemirovsky DR, Singh R, Jalalian A, Malik RD. Urologic dermatology: a comprehensive foray into the noninfectious etiologies of balanitis. Int J Dermatol 2021; 61:1467-1478. [PMID: 34826136 DOI: 10.1111/ijd.15985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/06/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
Balanitis is classically defined as inflammation of the glans penis, often also encompassing the prepuce (balanoposthitis). Several investigations have found that a sizable proportion of urology clinic visits are due to balanitis or related complaints. Balanitis can have numerous complications, including severe pain, urethral stenosis, phimosis, sexual dysfunction, and if untreated, malignancy. Unfortunately, there is no recent or comprehensive review that describes the various etiologies, clinical workup, and treatments for balanitis. Herein this review, we attempt to provide the reader with a complete and updated guide to balanitis in an attempt to improve clinical outcomes.
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Affiliation(s)
- Daniel R Nemirovsky
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Rohan Singh
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Aria Jalalian
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Rena D Malik
- Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Watchorn RE, Spencer AH, Kravvas G, Bunker CB. Reply to: Topical cyclosporine 5% cream in Zoon's balanitis resistant to other therapies: A case report. Dermatol Ther 2021; 35:e15215. [PMID: 34816551 DOI: 10.1111/dth.15215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Richard Edward Watchorn
- Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - George Kravvas
- Department of Dermatology, University College London Hospitals NHS Foundation Trust, London, UK
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Giorgio CMR, Briatico G, Licata G, Babino G, Fulgione E, Ronchi A, Argenziano G. Topical cyclosporine 5% cream in Zoon's balanitis resistant to other therapies: A case report. Dermatol Ther 2021; 34:e14807. [PMID: 33492699 DOI: 10.1111/dth.14807] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/09/2021] [Accepted: 01/20/2021] [Indexed: 11/26/2022]
Affiliation(s)
| | - Giulia Briatico
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaetano Licata
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Graziella Babino
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Andrea Ronchi
- Pathology Unit, University of Campania, Naples, Italy
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Mazzoni D, Pool L, Muir J. Pathologically oriented descriptive study of male genital circumcisions across medical and surgical specialties. Int J Dermatol 2020; 60:559-563. [PMID: 33319352 DOI: 10.1111/ijd.15359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Circumcision is one of the most frequently performed procedure by clinicians, yet its role and indication in clinical practice lacks consensus and remains unclear. We sought to evaluate a collection of male circumcisions to determine the range of indications, histopathological diagnoses, and type of clinicians associated with circumcision. METHODS We performed a retrospective descriptive cohort study of male patients who received a circumcision reported by one major dermatopathology laboratory between January 2017 and December 2018. Data were extracted from the histological report of the pathologist for each case. Patient age, type of clinician, clinical notes, and histopathological diagnosis were evaluated. RESULTS "/> A total of 406 circumcisions were identified. The median age for circumcision was 36 (IQR 16-61). Boys less than 18 years of age made up 24% (98/406). Histological diagnoses included normal (43/406, 11%), nonspecific inflammation (82/406, 20%), inflammatory conditions (264/406, 65%), infections (9/406, 2.2%), benign neoplasms (5/406, 1.0%), and scar tissue (3/406, 0.7%). The most common diagnosis was balanitis xerotica obliterans (226/406, 56%). Rarely, genital infections and neoplastic lesions were identified. Circumcisions were performed by urologists (289/406, 71.2%), general practitioners (76/406, 18.7%), general surgeons (32/406, 8%), pediatric surgeons (5/406, 1%), and dermatologists (4/406, 1%). The main indications for circumcision were phimosis (110/202, 54%), suspected lichen sclerosus (28/202, 14%), and balanitis (15/202, 7%). CONCLUSION Circumcision was performed for a broad range of genital dermatoses across various medical and surgical specialties. Few studies have described these observations. We discuss the common pathological conditions leading to circumcision and its role in diagnosis and treatment.
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Affiliation(s)
- Daniel Mazzoni
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Louis Pool
- Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia
| | - Jim Muir
- Mater Misericordiae Hospital, Brisbane, Queensland, Australia
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Delaleu J, Cavelier-Balloy B, Bagot M, Fouéré S, Dauendorffer JN. Zoon's plasma cell balanitis associated with male genital lichen sclerosus. JAAD Case Rep 2020; 6:670-672. [PMID: 32617384 PMCID: PMC7322490 DOI: 10.1016/j.jdcr.2020.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jérémie Delaleu
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,Centre for Genital and Sexually Transmitted Diseases, APHP, Saint-Louis Hospital, Paris, France.,University of Paris, Paris, France
| | | | - Martine Bagot
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,Centre for Genital and Sexually Transmitted Diseases, APHP, Saint-Louis Hospital, Paris, France.,University of Paris, Paris, France
| | - Sébastien Fouéré
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,Centre for Genital and Sexually Transmitted Diseases, APHP, Saint-Louis Hospital, Paris, France
| | - Jean-Noël Dauendorffer
- Department of Dermatology, APHP, Saint-Louis Hospital, Paris, France.,Centre for Genital and Sexually Transmitted Diseases, APHP, Saint-Louis Hospital, Paris, France
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12
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Conforti C, Giuffrida R, Di Meo N, Longone M, Vichi S, Colli C, Deinlein T, Vezzoni R, Retrosi C, Errichetti E, Cannavò SP, Zalaudek I, Dianzani C. Benign dermatoses of the male genital areas: A review of the literature. Dermatol Ther 2020; 33:e13355. [PMID: 32239734 DOI: 10.1111/dth.13355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/26/2020] [Indexed: 11/26/2022]
Abstract
The male genitalia are a common site of dermatoses. Patients with penile diseases often delay or avoid medical care due to anxiety and embarrassment. In this narrative review, we describe some of the main benign dermatoses localized to male genital, focusing on their epidemiology, clinical and dermoscopic features, as well as available therapies.
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Affiliation(s)
- Claudio Conforti
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy
| | - Nicola Di Meo
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Michela Longone
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Silvia Vichi
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Claudia Colli
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Teresa Deinlein
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Roberta Vezzoni
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Chiara Retrosi
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | | | - Iris Zalaudek
- Dermatology Clinic, University of Trieste, Hospital Maggiore, Trieste, Italy
| | - Caterina Dianzani
- Department of Plastic Reconstructive and Cosmetic Surgery, Dermatology Section, Campus Bio-Medico University Hospital, Rome, Italy
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Tchernev G, Temelkova I. Rituximab as most adequate treatment option for CD20-positive balanitis plasmacellularis Zoon! Dermatol Ther 2019; 32:e13139. [PMID: 31664744 DOI: 10.1111/dth.13139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 10/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Georgi Tchernev
- Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
| | - Ivanka Temelkova
- Onkoderma-Clinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
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Serrão LM, Sarmenghi KDDA, Pinto BCBP, de Miranda PB. Thalidomide in plasma cell balanitis refractory to conventional topical treatment. An Bras Dermatol 2019; 93:881-883. [PMID: 30484535 PMCID: PMC6256201 DOI: 10.1590/abd1806-4841.20187462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/20/2018] [Indexed: 11/22/2022] Open
Abstract
Zoon's plasma cell balanitis is a chronic genital inflammatory dermatosis that affects uncircumcised men, especially the elderly. It's characterized by painless erythematous plaques of orange hue, located on the glans penis and foreskin. Circumcision is the most effective treatment; however, it can be hard for patients to accept. As an alternative, topical calcineurin inhibitors are used, with good response. This article reports the case of a 32-year-old patient, HIV carrier, diagnosed with Zoon's plasma cell balanitis. Treatment with topical tacrolimus was administered, without improvement. A 6-week course of thalidomide resulted in complete remission of the lesions, without recurrence after eight months of follow-up.
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Affiliation(s)
- Lucas Mariano Serrão
- Dermatology Service, Hospital Santa Casa de Misericórdia de
Vitória, Vitória (ES), Brazil
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Kumar B. Circumcision is still the gold standard in management of plasma cell balanitis. Dermatol Ther 2018; 31:e12661. [PMID: 30246920 DOI: 10.1111/dth.12661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/30/2018] [Accepted: 06/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Bhushan Kumar
- Shalby Multi-Specialty Hospital, Mohali, Punjab, India
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Wollina U, Schönlebe J, Goldman A, Tchernev G, Lotti T. Simultaneous Occurrence of Balanoposthitis Circumscripta Plasmacellularis Zoon, Phimosis and in Situ Carcinoma of the Penis: Case Report with An Unusual Ulcerated Polypoid Variant of Zoon's Disease and a Carcinoma in Situ of Reserve Cell Type. Open Access Maced J Med Sci 2018; 6:61-63. [PMID: 29483984 PMCID: PMC5816318 DOI: 10.3889/oamjms.2018.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/17/2017] [Accepted: 10/29/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Zoon's balanitis is a benign disease characterized by an asymptomatic, chronic, solitary, shiny, red-orange plaque of the glans and/ or prepuce. In rare cases of Zoon's disease, penile squamous cell carcinoma developed in the chronic inflammatory lesions. CASE REPORT We report on a 68-year-old male patient presenting with phimosis and coexistent Zoon's disease and penile carcinoma in situ treated successfully by circumcision. CONCLUSION Coexistence of both lesions in contrast to the development of cancerous lesions within pre-existent Zoon's disease is a very rare observation.
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Affiliation(s)
- Uwe Wollina
- Städtisches Klinikum Dresden, Department of Dermatology and Allergology, 01067 Dresden, Germany
| | - Jacqueline Schönlebe
- Städtisches Klinikum Dresden - Institute of Pathology “Georg Schmorl”, Dresden, Germany
| | | | - Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
- Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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Lewin MR, Hick RW, Selim MA. Lichenoid Dermatitis of the Vulva: Diagnosis and Differential Diagnosis for the Gynecologic Pathologist. Adv Anat Pathol 2017; 24:278-293. [PMID: 28654444 DOI: 10.1097/pap.0000000000000160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Inflammatory processes affecting the vulva may present a unique challenge due to location specific changes. Different factors are behind the intricacy in the presentation of vulvar dermatoses. First, the vulva is lined by different epithelia (hair-bearing keratinized epithelium, modified mucosa, and mucosa). Furthermore, among other factors, this organ is exposed to friction, occlusion, and trauma. Lastly, as there is a tendency to look for health care advice at an advanced stage of the disease, the lesion may be modified by secondary changes due to self-treatment. This article describes the clinical presentation and pathologic features of vulvar dermatoses with a lichenoid pattern and highlights practical points for their diagnoses.
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Bari O, Cohen PR. Successful Management of Zoon's Balanitis with Topical Mupirocin Ointment: A Case Report and Literature Review of Mupirocin-Responsive Balanitis Circumscripta Plasmacelluaris. Dermatol Ther (Heidelb) 2017; 7:203-210. [PMID: 28382428 PMCID: PMC5453920 DOI: 10.1007/s13555-017-0178-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Zoon's 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. A patient with a biopsy-confirmed diagnosis of BCP who was successfully treated with topical mupirocin ointment is described. METHODS The PubMed database was searched with the key words: bactroban, balanitis, cell, circumscripta, mupirocin, plasma, plasmacellularis, tacrolimus, Zoon. The papers generated by the search and their references were reviewed. RESULTS Treatments for BCP have previously included circumcision and topical calcineurin inhibitors. Our patient with BCP rapidly resolved after initiating treatment with mupirocin 2% ointment. CONCLUSION BCP is a benign dermatosis affecting the glans penis and foreskin. We confirm an earlier observation demonstrating successful management of this condition with topical mupirocin 2% ointment. Previously reported therapies include circumcision, topical calcineurin inhibitors, phototherapy, and laser therapy. However, based on our observations, topical mupirocin 2% ointment therapy may be considered for the initial management of patients with suspected BCP. Prompt response to mupirocin 2% ointment is highly suggestive of the diagnosis of BCP since morphologically similar skin conditions do not respond to this treatment.
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Affiliation(s)
- Omar Bari
- School of Medicine, University of California San Diego, La Jolla, CA, USA.
| | - Philip R Cohen
- Department of Dermatology, University of California San Diego, La Jolla, CA, USA.
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