engleski

Balanitis Circumscripta Plasmacellularis

Balanitis circumscripta plasmacellularis (BCP) is an idiopathic, benign condition of the elderly uncircumcised men genitalia. Etiology is unknown. It is presented as sharply demarcated bright red glistering patch on the glans and prepuce. Analogous lesions of the female genitalia are known as vulvitis plasmacellularis. Our purpose is to discuss histological patterns in BCP that are seen in our patients. Sequence of histopathologic changes is compatible with the thesis that balanitis of Zoon results from irritation or mild trauma affecting barely keratinized skin in a moist environment. The earliest histopathological changes are thickening of the epidermis, parakeratosis and a patchy lichenoid infiltrate of lymphocytes and some plasma cells. More advanced cases show atrophy of the epidermis, superficial erosions, scattering of neutrophils in the upper reaches of the epidermis, scant spongiosis, extravasation of erythrocytes and a much denser infiltrate with many plasma cells. At even later stages additional findings may be: subepidermal clefts, sometimes with loss of the entire epidermis, marked fibrosis of the superficial dermis, and many siderophages. Plasma cells usually exceed 50% of the present cells, although they can be assessed as low as few, moderately dense to dense infiltrate, but they could always be detected. Lymphocytes are constantly present, polymorphonuclear leucocytes are never predominant while eosinophils are sparse. Conclusion: Disorders that clinically mimic BCP are numerous and recognition of histopathologic features of BCP allows differentiation from premalignant, infective and other inflammatory penile lesions which may be more responsive to treatment.

Balanitis circumscripta plasmacellularis; inflammatory penil lesions

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