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Balanitis Circumscripta Plasmacellularis

  • Author: Noah S Scheinfeld, JD, MD, FAAD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Feb 09, 2016
 

Background

In 1952, J.J. Zoon[1] first recognized balanitis circumscripta plasmacellularis (plasma cell balanitis) is an idiopathic, rare, benign penile dermatosis. Balanitis circumscripta plasmacellularis is important to distinguish this benign condition from the clinically similar neoplastic erythroplasia of Queyrat. Whether plasma cell balanitis is a benign or premalignant condition is controversial.[2]

Immunohistologically, immunoglobulin E and immunoglobulin G are found to be major immunoglobulin classes in the plasma cellular infiltrate. Immunoglobulin M–positive cells are either absent or present in very low numbers. Although a specific allergen has not been identified, the findings suggest that this condition could be related to immediate hypersensitivity.

The kappa-to-lambda ratio is variable. This suggests a nonspecific polyclonal stimulation of B cells in the basis of balanitis circumscripta plasmacellularis (plasma cell balanitis), which might be caused by a persistent infection.

Other related Medscape Drugs and Diseases articles include Bowen Disease, Lichen Sclerosus et Atrophicus, Erythroplasia of Queyrat (Bowen Disease of the Glans Penis), Balanitis Xerotica Obliterans, and Balanitis in Emergency Medicine.

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Epidemiology

Frequency

Mallon et al[3] studied 357 male referral patients with genital skin disease. They studied a control group of 305 male dermatology clinic patients without genital skin disease over a 120-day period. Their goal was to investigate the relationship between circumcision and penile disease. Mallon et al[3] compiled the percentage of circumcision in the general male dermatology population. Zoon balanitis occurred in 27 patients. More patients had squamous cell carcinoma, bowenoid papulosis, and Bowen disease. They noted that every patient with Zoon balanitis, bowenoid papulosis, and nonspecific balanoposthitis had not been circumcised. A case of Zoon balanitis has been noted in Cotonous (Benin) in an HIV-positive man who was circumcised.[4]

In Edinburgh, Scotland, a genitourinary medicine clinic reported that of 226 patients examined over a 3-year period, 26 (10%) had Zoon plasma cell balanitis.[5]

Sex

Balanitis circumscripta plasmacellularis (plasma cell balanitis) affects males. Analogous lesions sharing both clinical and histologic features of balanitis circumscripta plasmacellularis (plasma cell balanitis) have been reported in women as vulvitis circumscripta plasmacellularis.

Age

Balanitis circumscripta plasmacellularis (plasma cell balanitis) is most common in middle-aged to older men, with cases reported in patients aged 20-88 years.

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Prognosis

The prognosis is excellent if appropriate treatment is rendered.

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Patient Education

For excellent patient education resources, visit eMedicineHealth's Men's Health Center. Also, see eMedicineHealth's patient education article Foreskin Problems.

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Contributor Information and Disclosures
Author

Noah S Scheinfeld, JD, MD, FAAD Assistant Clinical Professor, Department of Dermatology, Weil Cornell Medical College; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, New York Eye and Ear Infirmary; Assistant Attending Dermatologist, New York Presbyterian Hospital; Assistant Attending Dermatologist, Lenox Hill Hospital, North Shore-LIJ Health System; Private Practice

Noah S Scheinfeld, JD, MD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Abbvie<br/>Received income in an amount equal to or greater than $250 from: Optigenex<br/>Received salary from Optigenex for employment.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Janet Fairley, MD Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine

Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Federation for Medical Research, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

George C Keough, MD Chief, Clinical Assistant Professor, Department of Medicine, Dermatology Service, Eisenhower Army Medical Center

George C Keough, MD is a member of the following medical societies: American Academy of Dermatology and American Medical Association

Disclosure: Nothing to disclose.

Daniel S Lehman, MD Fellow in Minimally Invasive Urology/Oncology, Department of Urology, Columbia University Medical Center

Disclosure: Nothing to disclose.

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