Zoon Balanitis
Gonzalo De Toro, MD
Key Facts
Clinical Issues
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Benign process with chronic course, with only a few cases that respond to corticosteroids
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In men, most of the cases are cured by circumcision
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Laser ablation can also be effective
Microscopic Pathology
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Epithelium appears thinned and flattened
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Sometimes may be partially detached or even absent
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Mild spongiosis
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Dense lymphocytic lichenoid infiltrate in the upper and mid submucosa, with abundant mature plasma cells
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Epithelium with diamond- or lozenge-shaped, flattened keratinocytes
Top Differential Diagnoses
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Primary and secondary syphilis
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Cutaneous plasmacytosis
Zoon balanitis presents as an erythematous plaque that is often well demarcated  . |
Zoon balanitis histologically shows an atrophic epithelium with flattened diamond-shaped keratinocytes  and mild spongiosis. |
TERMINOLOGY
Synonyms
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Plasmacytosis mucosae
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Plasma cell balanitis
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Balanitis circumscripta plasmacellularis (men)
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Vulvitis circumscripta plasmacellularis (women)
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Plasma cell cheilitis (lip)
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Plasmocytosis circumorificialis (oral)
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Idiopathic lymphoplasmacellular mucositis-dermatitis (skin and mucosal surfaces)
Definitions
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Idiopathic lymphoplasmacellular mucositis-dermatitis is generic term for any inflammatory accumulation of plasma cells at mucosal or cutaneous sites
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Zoon balanitis is reserved for localized involvement of prepuce or glans penis
ETIOLOGY/PATHOGENESIS
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