RESUMEN
Zoon's balanitis is a rare genital dermatosis of unknown etiology, usually presenting as a red-orange macule or plaque with a «cayenne pepper¼ appearance on the glans and/or foreskin. Unfortunately, atypical presentations are not uncommon, including vegetating or ulcerative lesions. Usually, it affects middle-age to older uncircumcised men. Although it is a benign pathology, Zoon's balanitis may be superimposed on another inflammatory or neoplastic dermatosis. As topical treatments are generally non satisfactory and relapses are usual on treatment with-drawal, circumcision remains an interesting option with usually a rapid and complete remission of the symptoms.
La balanite de Zoon est une dermatose génitale peu fréquente d'étiologie inconnue, se présentant habituellement par une macule ou une plaque de couleur rouge- orange avec un aspect en «poivre de cayenne¼, sur le gland et/ou le prépuce. Néanmoins, des formes atypiques, végétantes ou ulcérées, sont possibles. Elle touche plus souvent l'homme d'âge moyen à avancé et non circoncis. Il s'agit d'une pathologie bénigne, mais qui peut se surajouter à d'autres dermatoses inflammatoires ou néoplasiques. Les traitements topiques ne sont pas très efficaces et entraînent généralement une récidive à l'arrêt, tandis que la circoncision permet souvent une disparition rapide et complète des symptômes.
Asunto(s)
Balanitis , Circuncisión Masculina , Enfermedades de la Piel , Masculino , Persona de Mediana Edad , Humanos , Balanitis/diagnóstico , Balanitis/terapia , Balanitis/patologíaRESUMEN
Reactive arthritis is an extremely rare spondyloarthritis that affects the peripheral joints and spine, resulting in common symptoms such as arthritis, urethritis, conjunctivitis, and mucocutaneous lesions. On rare occasions, oral lesions such as circinate erosions on the hard and soft palate, gums, tongue, and cheeks may occur. Reactive arthritis may develop during or after genitourinary or gastrointestinal bacterial infections such as Shigella, Salmonella, Yersinia, and Chlamydia. A 36-year-old man presented with circinate balanitis, urethral discharge, oligoarthralgia, conjunctivitis, lymphadenopathy, pharyngitis, and erythematous lesions on the palate. Culture examination showed presence of Neisseria gonorrhoeae and antibiotic treatment resulted in improvement of conjunctivitis and the lesions on the penis. However, severe oligoarthralgia, palatal erosions that increased in severity and size, and depilated areas on the tongue were observed. The definitive diagnosis was reactive arthritis. The prevalence of sexually transmitted infections is increasing, highlighting the need to increase awareness of associated risks such as reactive arthritis. Moreover, consideration of non-specific oral manifestations in a systemic context may aid in effective diagnosis and treatment, suggesting the need for multidisciplinary teams.
Asunto(s)
Artritis Reactiva/patología , Adulto , Artritis , Artritis Reactiva/tratamiento farmacológico , Artritis Reactiva/microbiología , Balanitis/microbiología , Balanitis/patología , Conjuntivitis Bacteriana/microbiología , Conjuntivitis Bacteriana/patología , Gonorrea/microbiología , Humanos , Masculino , Enfermedades de la Boca/microbiología , Enfermedades de la Boca/patología , Neisseria gonorrhoeae/aislamiento & purificación , Faringitis/microbiología , Faringitis/patología , Articulación Sacroiliaca/patología , Enfermedades Bacterianas de Transmisión Sexual/tratamiento farmacológico , Enfermedades Bacterianas de Transmisión Sexual/microbiología , Enfermedades Bacterianas de Transmisión Sexual/patología , Dolor de Hombro , Sexo Inseguro , Enfermedades Uretrales/microbiologíaAsunto(s)
Balanitis/patología , Liquen Plano/patología , Pene/patología , Adulto , Dermoscopía , Humanos , Masculino , Persona de Mediana Edad , Piel/patología , Adulto JovenRESUMEN
We present a man in his 70s with a hyperkeratotic whitish plaque over the internal prepuce and glans. The lesion was slowly growing for four years prior to presentation and was resistant to several topical treatments. The histological examination of the lesion revealed marked hyperkeratosis and pseudoepitheliomatous hyperplasia, supporting the diagnosis of pseudoepitheliomatous, keratotic, and micaceous balanitis. It is important to be aware of this uncommon but potentially malignant condition affecting elderly men.
Asunto(s)
Balanitis/patología , Epitelio/patología , Queratosis/patología , Liquen Escleroso y Atrófico/diagnóstico , Lesiones Precancerosas/patología , Anciano , Balanitis/diagnóstico , Diagnóstico Diferencial , Humanos , Hiperplasia , Masculino , Lesiones Precancerosas/diagnósticoAsunto(s)
Balanitis/tratamiento farmacológico , Carcinoma de Células Escamosas/prevención & control , Imiquimod/administración & dosificación , Neoplasias del Pene/prevención & control , Lesiones Precancerosas/tratamiento farmacológico , Administración Tópica , Adulto , Balanitis/diagnóstico , Balanitis/patología , Carcinoma de Células Escamosas/patología , Progresión de la Enfermedad , Humanos , Masculino , Neoplasias del Pene/patología , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Resultado del TratamientoAsunto(s)
Antibacterianos/administración & dosificación , Balanitis/diagnóstico , Mupirocina/administración & dosificación , Enfermedades de la Piel/diagnóstico , Administración Cutánea , Balanitis/tratamiento farmacológico , Balanitis/patología , Biopsia , Diagnóstico Diferencial , Prepucio/efectos de los fármacos , Prepucio/patología , Humanos , Masculino , Pomadas , Piel/efectos de los fármacos , Piel/patología , Enfermedades de la Piel/tratamiento farmacológico , Enfermedades de la Piel/patología , Resultado del TratamientoAsunto(s)
Balanitis/diagnóstico , Dermoscopía/métodos , Inmunocompetencia , Adolescente , Balanitis/patología , Humanos , MasculinoRESUMEN
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.
Asunto(s)
Humanos , Masculino , Adulto , Células Plasmáticas/patología , Talidomida/uso terapéutico , Balanitis/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Balanitis/patología , Resultado del Tratamiento , Infecciones Oportunistas Relacionadas con el SIDA/patologíaRESUMEN
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.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Balanitis/tratamiento farmacológico , Células Plasmáticas/patología , Talidomida/uso terapéutico , Infecciones Oportunistas Relacionadas con el SIDA/patología , Adulto , Balanitis/patología , Humanos , Masculino , Resultado del TratamientoAsunto(s)
Balanitis/cirugía , Circuncisión Masculina , Prepucio/cirugía , Células Plasmáticas/patología , Administración Cutánea , Adulto , Anciano , Antiinfecciosos/administración & dosificación , Antiinflamatorios/administración & dosificación , Balanitis/tratamiento farmacológico , Balanitis/patología , Biopsia , Quimioterapia Combinada , Prepucio/efectos de los fármacos , Prepucio/patología , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana Edad , Células Plasmáticas/efectos de los fármacos , Resultado del TratamientoAsunto(s)
Balanitis/patología , Dermoscopía , Células Plasmáticas/patología , Antibacterianos/administración & dosificación , Antiinflamatorios no Esteroideos/administración & dosificación , Balanitis/diagnóstico , Balanitis/tratamiento farmacológico , Betametasona/administración & dosificación , Biopsia , Ácido Fusídico/administración & dosificación , Glucocorticoides/administración & dosificación , Humanos , Lactante , Masculino , Tacrolimus/administración & dosificación , Tacrolimus/análogos & derivadosRESUMEN
BACKGROUND: The term balanitis includes a variety of inflammatory skin diseases involving the glans penis whose clinical diagnosis may be challenging. A biopsy is often required to obtain a definitive diagnosis, although it is barely accepted by patients. Reflectance confocal microscopy (RCM), that provides a real-time, en face imaging of the epidermis and upper dermis, is currently utilized for the diagnosis of some neoplastic and inflammatory skin diseases. The aim of this study was to analyze the RCM handheld findings of some common balanitis and to correlate them with dermatoscopy and histopathological features. MATERIALS AND METHODS: Thirty-two patients with biopsy-proven diagnosis of psoriatic balanitis (10 patients), Zoon's balanitis (11 patients) and lichen sclerosus et atrophicus (11 patients) were evaluated using a handheld RCM device and ×10 dermatoscopy. RESULTS: At the end of the study, each disorder presented specific RCM patterns that correlated with dermatoscopy and histopathological findings. CONCLUSION: The use of handheld RCM as complementary tool in everyday clinical practice for the evaluation of inflammatory diseases involving sensitive areas such as male genitalia, may contribute to reduce the need of invasive procedures.
Asunto(s)
Balanitis/patología , Dermoscopía/métodos , Liquen Escleroso y Atrófico/patología , Microscopía Confocal/métodos , Pene/patología , Psoriasis/patología , Adulto , Anciano , Biopsia , Humanos , Microscopía Intravital , Masculino , Persona de Mediana EdadAsunto(s)
Balanitis/patología , Enfermedades de la Piel/patología , Adulto , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
INTRODUCTION: Zoon balanitis is an idiopathic benign inflammatory condition of the glans penis and prepuce. A patient with biopsy confirmed diagnosis of Zoon balanitis who was successfully treated with topical mupirocin ointment monotherapy is described.
METHOD: A search using PubMed database was performed using the following terms: Zoon balanitis (cases, diagnosis, treatment of), balanitis circumscripta plasmacellularis, and mupirocin. Relevant papers and their reference citations were reviewed and evaluated.
RESULTS: The gold standard of treatment for Zoon balanitis has previously been circumcision. More recently, topical calcineurin inhibitors have been shown to be effective. Our patient had successful resolution of his Zoon balanitis after 3 months of mupirocin ointment monotherapy.
DISCUSSION: Zoon balanitis is a benign inflammatory dermatosis. Previous successful treatment modalities include circumcision, phototherapy, laser therapy, and topical calcineurin inhibitors. Topical mupirocin ointment twice daily resulted in resolution of Zoon balanitis in our patient. Additional evaluation of mupirocin ointment as a therapeutic agent should be considered as a potential first-line therapy in patients with Zoon balanitis.
J Drugs Dermatol. 2017;16(3):285-287.
.Asunto(s)
Antibacterianos/uso terapéutico , Balanitis/diagnóstico , Balanitis/terapia , Mupirocina/uso terapéutico , Antibacterianos/administración & dosificación , Antiinfecciosos Locales/uso terapéutico , Balanitis/etiología , Balanitis/patología , Biopsia , Inhibidores de la Calcineurina/uso terapéutico , Circuncisión Masculina , Clotrimazol/administración & dosificación , Clotrimazol/uso terapéutico , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Mupirocina/administración & dosificación , Pomadas , Pene/patología , Fototerapia , Resultado del TratamientoRESUMEN
We describe the case of a 73-year-old man who presented with a 10-month history of an ulcerating lesion on the glans penis. Initially this was thought to be an invasive squamous cell carcinoma but a biopsy showed histological features consistent with necrotizing granulomatous inflammation. Extensive serological, immunological and microbiological tests only showed a positive antinuclear and perinuclear antineutrophil cytoplasmic antibodies indicating a possible autoimmune aetiology but an underlying systemic cause was not identified. Treatment with oral corticosteroids limited the inflammatory process but due to the gross destruction of the glans penis, he still required a glansectomy and split-skin graft reconstruction from which he recovered well. Although this patient ultimately required surgery for this rare presentation, this case highlights the differential diagnosis of penile ulceration (that transcends neoplasia) and the importance of performing and interpreting penile biopsies before undertaking potentially mutilating definitive surgery.