Balanite plasmocitária de Zoon: relato de dois casos tratados com pimecrolimo

Abstract

Inicialmente, denominada "Balanoposthite chronique circonscrite benigne a plasmocytes", a balanite plasmocitária de Zoon é uma dermatose inflamatória crônica da glande e prepúcio afetando homens não circuncisados. As diferentes opções de tratamento para esta afecção apresentam frequentemente resultados parciais. Relatos têm demonstrado sucesso terapêutico, com o uso de tacrolimo tópico. Relatamos o uso de pimecrolimus, um homólogo de tacrolimo, com boa resposta. Dois doentes do sexo masculino, com diagnóstico de Balanite de Zoon confirmado através de biópsia, foram submetidos a um tratamento diário com pimecrolimus tópico a 1%, com importante melhora da doença após 6 semanas para o paciente, 1 e 8 semanas para o 2. Conclusão: O pimecrolimus em creme pode ser uma opção para o tratamento da doença

Therapeutic Efficacy of Topical Calcineurin Inhibitors in Plasma Cell Balanitis: Case Series and Review of the Literature

“…However, these treatment options are often rejected by patients, since they are considered as quite aggressive. Therefore, several topical (or intralesional) therapies have been tried with various results, such as corticosteroids, antibacterial and antifungal agents, fusidic acid, trimovate, tacrolimus and pimecrolimus [3,4,5,6,7,8,9,10]. …”

“…Last, Roé et al [8 ]presented 3 cases treated with twice daily applications of 0.1% topical tacrolimus that reported complete disappearance of symptoms and total remission of the lesion between week 3 and week 4. Regarding treatment of PCBZ using 0.1% topical pimecrolimus twice daily, Bardazzi et al [3] reported 2 cases with complete remission or great improvement after 2 months, while Delgado et al [4] presented 2 cases with great improvement after 6-8 weeks of application. Moreover, Stinco et al [10] published 3 cases with partial to complete resolution of the lesions within a month.…”

“…Recently several reports of PCBZ and PCV treated with calcineurin inhibitors, tacrolimus and pimecrolimus, have been reported in the literature [3,4,5,6,7,8,9,10,11]. We present 9 cases of PCBZ treated with tacrolimus 0.1% ointment (Protopic, Toyama, Japan) and review the literature of PCBZ and PCV and their response to these topical immunomodulators.…”

Zoon balanitis: A comprehensive review

“…Furthermore, pimecrolimus leads to inhibition of histamine release by mast cells, which may result in improvement of the symptoms. [343536] TCI are being used in the management of several dermatological conditions, due to their efficacy, safety profile, lack of rebound effect, and absence of tachyphylaxis. Most of the researchers have used TCIs in ZB for 4–8 weeks resulting in significant clinical improvement without any severe side effect.…”

“…Most of the researchers have used TCIs in ZB for 4–8 weeks resulting in significant clinical improvement without any severe side effect. [282930313233343536] However, concern regarding its relationship with carcinogenesis has been mentioned in the literature. [223940] Therefore, before starting treatment with these agents, carcinogenic and precarcinogenic conditions should be carefully ruled out as they may promote evolution of preexisting neoplastic conditions [Table 2]…”