Pseudoepitheliomatous, keratotic, and micaceous balanitis with Koilocytes

Chandrakala, C; Prabhash, Kumar; Nilavu, J; Shanthi, D.

doi:10.4103/ijstd.ijstd_113_15

Cited by 1 publication

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Excision of localized disease proved effective for one of our patients; there are also nine cases of this previously described, with varying results. 6,7,[17][18][19]23,35,38,39 Other modalities published include partial penectomy (3 cases), [40][41][42] cryotherapy (3 cases), 10,17,27 radiotherapy (2 cases), 9,43 acitretin (2 cases) 24,26 and photodynamic therapy (1 case). 44…”

Section: Discussionmentioning

confidence: 99%

“…17 One case was deemed to have koilocytes on histology, however neither HPV DNA analysis or p16 staining were performed and published histological photographs were not of adequate quality for interpretation. 18 Kang et al described a further case in association with HPV detection on PCR (no subtype given), with no evidence of HPV on histology (p16 stain not performed). 19 It is important to consider these observations in the context of the ubiquitous nature of HPV; the estimated prevalence of genital HPV in the general male population is 45.2%, with 25.1% harbouring high risk subtypes.…”

Section: Discussionmentioning

confidence: 99%

“…Two men with PEKMB had low‐risk HPV DNA detected, though no clinical or histological evidence of HPV, including negative p16 staining 17 . One case was deemed to have koilocytes on histology, however neither HPV DNA analysis or p16 staining were performed and published histological photographs were not of adequate quality for interpretation 18 . Kang et al described a further case in association with HPV detection on PCR (no subtype given), with no evidence of HPV on histology (p16 stain not performed) 19 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pseudoepitheliomatous keratotic and micaceous balanitis: a series of eight cases

Spencer

Watchorn

Kravvas

et al. 2022

Acad Dermatol Venereol

View full text Add to dashboard Cite

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.

show abstract