Balanitis Circumscripta Plasmacellularis

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

Background

In 1952, JJ Zoon [1] first recognized balanitis circumscripta plasmacellularis (plasma cell balanitis) as an idiopathic, rare, benign penile dermatosis. It is important to distinguish balanitis circumscripta plasmacellularis (a 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 as the basis of balanitis circumscripta plasmacellularis (plasma cell balanitis), which might be caused by a persistent infection.

Other related Medscape Drugs & 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 patient education resources, visit the Men's Health Center. Also, see the patient education article Foreskin Problems.

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