By Gary M. White, MD
Zoon's balanitis, also known as balanitis plasmocellularis, is an uncommon, benign, idiopathic, inflammatory condition of the penis in older, uncircumcised men.
A well-demarcated, fixed, red area on the glans penis is seen. Usually the involved skin is constantly covered by foreskin. Thus, this condition preferentially affects uncircumcised males.
A biopsy is critical to exclude SCC in situ (erythroplasia of Queyrat). A medium-potency topical steroid for 6-8 weeks and then tapered to use as necessary is appropriate. Topical tacrolimus 0.1% ointment or pimecrolimus cream BID both have been reported effective. Fusidic acid and CO2 laser have been used.
One may ask the patient if there is any way to pull the foreskin back and expose the area more, letting it dry out. This may clear any involved skin that can be allowed to "dry."
Circumcision cures virtually all patients. However, many elderly patients prefer to avoid circumcision.
Same patient as the one above. You can see how the glans is affected only where the foreskin provides a constant covering. The area that stays dry is uninvolved.
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