Zoon's Balanitis: Benign or Premalignant Lesion?

Abstract

Zoon's balanitis or balanitis circumscripta plasmacellularis is a chronic disease of unknown origin. This condition usually manifests in middle-aged or elderly uncircumcised men. Although of unknown etiology, different factors have been reported to be involved in its genesis (local infections, poor hygiene, heat, friction, and constant rubbing). It is generally considered to be a benign condition, and its association with malignancies has been rarely reported. We report the case of an uncircumcised man, who developed clinically and histopathologically evident squamous cell carcinoma of the penis in an area affected by Zoon's balanitis.

Fig. 1

Squamous cell carcinoma – erythematous, glistening, well-demarcated, highly indurated lesion on glans and prepuce.

Fig. 2

a Penile surgical biopsy overview (haematoxylin and eosin; original magnification ×4). b Nests of atypical cells scattered throughout the full thickness of the epidermis and infiltrating the dermis with mixed inflammatory infiltrate (haematoxylin and eosin; original magnification ×10). c Dense dermal inflammatory infiltrate constituted predominantly by plasma cells (haematoxylin and eosin; original magnification ×40).