Differentiation Between Balanitis and Carcinoma In Situ Using Reflectance Confocal Microscopy

Arzberger, Edith; Komericki, Peter; Ahlgrimm‐Siess, Verena; Massone, Cesare; Chubisov, Dmitry; Hofmann‐Wellenhof, Rainer

doi:10.1001/jamadermatol.2013.2440

Cited by 21 publications

(26 citation statements)

References 28 publications

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“…Similar lesions in other mucosal sites, such as the vaginal, perianal, and oral regions, have been reported [7, 12, 13]. Reflectance confocal microscopy may help avoid penile biopsy by differentiating between balanitis and carcinoma in situ [14]. …”

Section: Discussionmentioning

confidence: 68%

Successful Management of Zoon’s Balanitis with Topical Mupirocin Ointment: A Case Report and Literature Review of Mupirocin-Responsive Balanitis Circumscripta Plasmacelluaris

Bari

Cohen

2017

Dermatol Ther (Heidelb)

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IntroductionZoon’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.MethodsThe 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.ResultsTreatments for BCP have previously included circumcision and topical calcineurin inhibitors. Our patient with BCP rapidly resolved after initiating treatment with mupirocin 2% ointment.ConclusionBCP 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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Section: Discussionmentioning

confidence: 68%

Successful Management of Zoon’s Balanitis with Topical Mupirocin Ointment: A Case Report and Literature Review of Mupirocin-Responsive Balanitis Circumscripta Plasmacelluaris

Bari

Cohen

2017

Dermatol Ther (Heidelb)

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“…However, it has been suggested that the presence of plasma cell infiltrate is relatively not specific for the diagnosis of PCVZ [22,24]. Recently, reflectance confocal microscopy, an in vivo imaging method to get morphological information about architecture and single cells in the skin, was shown to be helpful in differentiating between balanitis and carcinoma in situ and avoiding biopsies at this sensitive site [25]. …”

Section: Discussionmentioning

confidence: 99%

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

Kyriakou¹,

Patsatsi²,

Patsialas

et al. 2014

Dermatology

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Plasma cell balanitis of Zoon (PCBZ) and plasma cell vulvitis (PCV) are characterized as idiopathic, benign, chronic irritant mucositis. The clinical symptoms and signs usually persist or reappear after treatment withdrawal. Therefore, many therapies have been tried and are available. Recently, several reports of PCBZ and PCV treated with calcineurin inhibitors, tacrolimus and pimecrolimus, have been reported in the literature. We present 9 cases of PCBZ treated with tacrolimus 0.1% ointment (Protopic, Toyama, Japan) that showed good therapeutic results within 4 weeks of treatment, and we review the literature of PCBZ and PCV and their response to these topical immunomodulators. Based on the current literature and on the anecdotal experience, we believe that topical calcineurin inhibitors may serve as a therapeutic option in recalcitrant plasma cell balanitis and vulvitis.

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“…[25] Generally, genital skin is suitable for confocal microscopy because of its thin or absent cornified layer. It is very useful tool to differentiate ZB from CIS.…”

Section: Diagnosismentioning

confidence: 99%

“…The most relevant features for CIS on RCM are atypical honeycomb pattern, disarranged epidermal pattern/focal loss, and round nucleated cells. [25] A nucleated honeycomb pattern and vermicular vessels is a clue for benign inflammatory genital skin disease. In contrast to this, the adjacent normal skin shows a typical honeycomb pattern and round papillary vessels.…”

Section: Diagnosismentioning

confidence: 99%

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Zoon balanitis: A comprehensive review

Dayal

Sahu

2016

Indian J Sex Transm Dis

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The diagnosis and management of nonvenereal diseases are always a tough challenge for the dermatologist due to lack of studies on its diagnostic criteria and standard treatment guidelines. Zoon balanitis (ZB) is one of the benign nonvenereal dermatoses, which presents as a solitary, persistent erythematous plaque usually on the glans penis primarily in the uncircumcised, middle-aged to old-aged men. Although it was described by Zoon in 1952, its etiopathogenesis still remains hypothetical. This article provides an overview of the epidemiology, clinical presentation, histopathological features, and diagnostic criteria and diagnostic methods of ZB. In addition to this, it is rather very important to differentiate this lesion from its clinical equivocal lesions such as erythroplasia of Queyrat, infective and other inflammatory penile dermatoses, which has been discussed in this review. The treatment modalities have also been reviewed in details, and the importance of circumcision as the treatment of choice has been emphasized.

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Differentiation Between Balanitis and Carcinoma In Situ Using Reflectance Confocal Microscopy

Abstract: We were able to differentiate between balanitis and CIS. Reflectance confocal microscopy may help to avoid biopsies at this sensitive site.

Cited by 21 publications

References 28 publications

Successful Management of Zoon’s Balanitis with Topical Mupirocin Ointment: A Case Report and Literature Review of Mupirocin-Responsive Balanitis Circumscripta Plasmacelluaris

Successful Management of Zoon’s Balanitis with Topical Mupirocin Ointment: A Case Report and Literature Review of Mupirocin-Responsive Balanitis Circumscripta Plasmacelluaris

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

Zoon balanitis: A comprehensive review

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