Nail‐like presentation of pseudoepitheliomatous keratotic and micaceous balanitis successfully treated with topical 5% 5‐fluorouracil: a case report and review of the literature

Sil, Abheek; Bhanja, Dibyendu Bikash; Panigrahi, Avik; Biswas, Surajit Kumar

doi:10.1111/ijd.15877

Cited by 2 publications

(3 citation statements)

References 4 publications

(11 reference statements)

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“…One patient initially had residual disease at the graft site, treated successfully with salicylic acid and 5‐flurouracil. Of 18 reported cases of the use of 5‐flurouracil, 6,10,12,17,24–36 significant improvement was seen in just five (27.7%) 25,27,33,36,37 . Two cases treated with salicylic acid reported little improvement 31,32 .…”

Section: Discussionmentioning

confidence: 98%

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Pseudoepitheliomatous keratotic and micaceous balanitis: a series of eight cases

Spencer

Watchorn

Kravvas

et al. 2022

Acad Dermatol Venereol

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Background Pseudoepitheliomatous keratotic and micaceous balanitis (PEKMB) is a clinicopathological entity characterized clinically by micaceous scale on the glans, and histologically by acanthosis, hyperkeratosis and pseudoepitheliomatous hyperplasia. We present a series of eight cases of this rare condition, the first series of more than two cases to be reported. Objectives To determine the clinical and histological characteristics of cases of PEKMB, and evaluate treatments used and clinical course. Methods This monocentric case series was conducted at the University College London Hospitals tertiary male genital dermatology clinic between April 2018 and August 2020. Eight patients with PEKMB were evaluated. Data were collected on demographics, clinical presentation, histological features, presence of human papilloma virus (HPV), history of lichen sclerosus, treatment of PEKMB and subsequent response, and presence or development of squamous cell carcinoma (SCC) or penile intraepithelial neoplasia (PeIN) during follow‐up. Results Eight Caucasian males presented with clinical and histological evidence of PEKMB. Seven had a background of lichen sclerosus; two had failed treatment with superpotent topical steroids and four had symptoms for three or more years prior to circumcision. There was no clinical or histological relationship with HPV infection, and p16 staining was negative. HPV PCR, performed in two cases, was negative. Basal atypia, insufficient to amount to PeIN, was present in six patients. One patient progressed to PeIN during follow‐up, and no patient progressed to invasive malignancy. Five patients were treated successfully with glans resurfacing and split skin graft reconstruction. Conclusions Our observations demonstrate that PEKMB represents a form of chronic, undiagnosed or misdiagnosed, inadequately treated or treatment refractory, unstable lichen sclerosus. The significant potential for squamous carcinogenesis (differentiated PeIN and verrucous carcinoma) can be mitigated by timely diagnosis and treatment. Glans resurfacing and split skin graft reconstruction appears to be a successful treatment modality in patients with refractory disease.

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Section: Discussionmentioning

confidence: 98%

“…Of 18 reported cases of the use of 5-flurouracil, 6,10,12,17,[24][25][26][27][28][29][30][31][32][33][34][35][36] significant improvement was seen in just five (27.7%). 25,27,33,36,37 Two cases treated with salicylic acid reported little improvement. 31,32 However, these topical treatments were not used as an adjunct to surgery.…”

Section: Discussionmentioning

confidence: 99%

Pseudoepitheliomatous keratotic and micaceous balanitis: a series of eight cases

Spencer

Watchorn

Kravvas

et al. 2022

Acad Dermatol Venereol

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show abstract

“…[ 7 ] Recently cutaneous horns developing from pseudoepitheliomatous keratotic and micaceous balanitis have also been reported. [ 8 , 9 ] Our case is unique and rare in presentation on account of the co-existence of squamous cell carcinoma, cutaneous horn, and chronic DLE lesion in a rare location.…”

mentioning

confidence: 94%

A squamous cell carcinoma presenting as a giant cutaneous horn over the lower lip in a patient with chronic disseminated lupus erythematosus

Gupta

Meghwal

Balai

et al. 2023

Indian Dermatol Online J

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Nail‐like presentation of pseudoepitheliomatous keratotic and micaceous balanitis successfully treated with topical 5% 5‐fluorouracil: a case report and review of the literature

Cited by 2 publications

References 4 publications

Pseudoepitheliomatous keratotic and micaceous balanitis: a series of eight cases

Pseudoepitheliomatous keratotic and micaceous balanitis: a series of eight cases

A squamous cell carcinoma presenting as a giant cutaneous horn over the lower lip in a patient with chronic disseminated lupus erythematosus

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