Pseudoepitheliomatous keratotic and micaceous balanitis with malignant transformation

Abstract

Pseudoepitheliomatous, keratotic and micaceous balanitis (PKMB) is a non-venereal and extremely rare pre-malignant condition characterized by silvery white plaque with micaceous scaling on glans seen in elderly uncircumcised men. Symptoms include phimosis, pain, and interference with sexual activity. Herein we present a young, 40-year-old male with PKMB of 5 years duration with deviation of urinary stream and histology showing acanthosis, hyperkeratosis with features of cellular atypia and abnormal mitosis suggestive of malignant transformation.

Surgical managements of pseudoepitheliomatous keratotic and micaceous balanitis: A case report

“…Since its first report in 1961, less than 30 case reports have been reported worldwide [1]. Although a topical 5-fluorouracil (5-FU) treatment has been proposed as a golden standard treatment for early lesions [[2], [3], [4], [5]], surgical treatment is required if the recurrence continues despite the application of 5-FU cream or if the cream is not available [6,7]. Herein, we report a case of pseudoepitheliomatous keratotic and micaceous balanitis in a patient who underwent two surgical procedures, since the 5-FU cream was not available.…”

Pseudoepitheliomatous keratotic and micaceous balanitis: A literature review

“…In symptomatic patients, itching, irritation, erythema, pain, soreness, pruritus, urinary symptoms, sexual symptoms and telangiectasia were reported. 1,2,[11][12][13][14][16][17][18][19] Urinary and sexual symptoms occurred in 16.6% (n = 4) and in 8.3% (n = 2) of the patients, respectively. The duration of symptoms ranged from 2 months to 30 years, and 10 patients (41.6%) had a history of phimosis.…”

“…The duration of symptoms ranged from 2 months to 30 years, and 10 patients (41.6%) had a history of phimosis. [6][7][8][9]11,12,15,17,19,20 At the time of disease presentation, 19 patients (79.1%) were circumcised. Inguinal lymphadenopathy was not reported in the included patients.Histopathology of the lesion revealed hyperkeratosis and acanthosis in 14 patients.…”

“…Most patients (58.3%) did not have any cellular abnormality or atypia, with only four patients showing features of cellular atypia. 6,12,14,20 Eight patients (33.3%) had a 'pushing' pattern, characteristic of verrucous carcinoma. 2,3,6,8,14,17,19 Five patients progressed to more advanced disease: carcinoma in situ or Bowen disease (n = 2), 12,16 well differentiated infiltrative squamous cell carcinoma (n = 2) and spindle cell fibrosarcoma (n = 1).…”

“…24 Clinically, PKMB can present as monofocal or multifocal plaques with micaceous scaling on the glans. 12 It can be asymptomatic or can cause pain, pruritus, telangiectasia and other urinary symptoms when it involves the urethral meatus. 22 Patients with LS present mainly with sexual difficulties, such as erectile dysfunction and dyspareunia.…”