Therapeutic efficacy of topical calcineurin inhibitors in plasma cell balanitis: case series and review of the literature

Abstract

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.