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Plasma Cell Balanitis

Last updated Dec. 23, 2018

Approved by: Maulik P. Purohit MD, MPH

Plasma Cell Balanitis is a rare and benign skin condition that generally affects middle-aged men.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Balanitis Circumscripta Plasmacellularis
  • Zoon Balanitis

What is Plasma Cell Balanitis? (Definition/Background Information)

  • Plasma Cell Balanitis is an inflammatory skin condition affecting the foreskin and penis head of penis; numerous plasma cells (type of inflammatory cells) are observed in this condition, when the tissue biopsy is observed under the microscope by a pathologist
  • It usually leads to the formation of a solitary lesion that is a well-defined red patch
  • In a majority of men, there may be no signs and symptoms, while some may have itchiness (pruritus) and/or pain
  • Plasma Cell Balanitis may be diagnosed through physical examination, medical history evaluation, blood tests, and confirmed through a tissue biopsy
  • In most cases, no treatment is necessary for Plasma Cell Balanitis. However, for severe conditions and cosmetic concerns, topical creams, topical lotions, and even surgery may be considered
  • The prognosis of Plasma Cell Balanitis is excellent with suitable treatment, including surgery or laser therapy

Who gets Plasma Cell Balanitis? (Age and Sex Distribution)

  • Plasma Cell Balanitis is a rare and benign skin condition that generally affects middle-aged men. However, older men may also be affected
  • The condition can occur worldwide and no geographical preference is seen
  • Individuals of all racial and ethnic background may be affected

What are the Risk Factors for Plasma Cell Balanitis? (Predisposing Factors)

  • The risk factors for Plasma Cell Balanitis are largely unknown
  • However, uncircumcised men have a higher risk of the condition over circumcised men

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Plasma Cell Balanitis? (Etiology)

  • The exact cause of development of Plasma Cell Balanitis is unknown
  • Some researchers have proposed that poor hygiene, bacterial infections, excessive sweating, or trauma may be potential causative factors
  • It is not a sexually-transmitted condition and is non-contagious

What are the Signs and Symptoms of Plasma Cell Balanitis?

The signs and symptoms of Plasma Cell Balanitis may include:

  • The presence of a single, inflamed, red patch that is normally well-defined
  • The skin patches may be itchy
  • The signs and symptoms may develop over weeks and months and may be present for a long period of time
  • The lesion usually occurs on the penis head (glans penis) and foreskin (prepuce)
  • They may ulcerate and bleed, which can lead to an infection
  • Individuals may experience discomfort and pain during sexual intercourse
  • The degree of severity may differ from one individual to another, though it is generally asymptomatic in many.

How is Plasma Cell Balanitis Diagnosed?

The following are the diagnostic methods to help identify Plasma Cell Balanitis:

  • A thorough physical examination and a complete medical history are very crucial; a dermatologist will carefully examine the lesions to help in the diagnosis
  • Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Blood tests, to rule out other causes such as infections
  • Potassium hydroxide (KOH) test: The KOH prep involves microscopic observation of a sample for structures belonging to fungi. The sample required is skin scraping. The process involves gently scraping the infected skin and collection into a sterile container
  • Gram stain examination: The sample to be analyzed is examined under a microscope for the presence of bacteria
  • A biopsy of the lesion is usually performed to confirm the diagnosis. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
  • Note: The tissue biopsy is typically performed to rule out other, more serious conditions such as squamous cell carcinoma in situ.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Plasma Cell Balanitis?

Even though there are no significant complications due to Plasma Cell Balanitis, a few may include:

  • Severe infection necessitating surgical treatment
  • Individuals may have stress and anxiety issues fearing that the condition is a sexually-transmitted infection
  • Some individuals have cosmetic concerns due to the appearance of the lesions

How is Plasma Cell Balanitis Treated?

There is no definitive cure for Plasma Cell Balanitis, but a variety of treatment options may be considered that may benefit the affected individuals.  These include:

  • Topical steroidal creams and lotions; topical tacrolimus is also helpful in some
  • Topical antibiotic and antifungal creams
  • In some cases, surgical excision is a treatment option, usually when the lesions present cosmetic concerns. A laser surgery generally results in lesser side effects and ensures a faster healing
  • In some individuals, circumcision can bring about a complete cure
  • Providing reassurance and helping with anxiety feelings may be sufficient treatment for some
  • Some individuals may consult healthcare professionals to rule out sexually-transmitted infections (if any)
  • In case of severe infection, complete surgical excision with skin grafting may be necessary

In a majority of cases, no treatment is required for Plasma Cell Balanitis, since it is a benign and normally asymptomatic condition.

A few tips for self-care and personal hygiene include:

  • Keep the affected skin (region) clean and dry
  • Completely avoid scratching the affected areas
  • A comfortable, cool bath may help soothe the skin; but, avoid excessive washing and scrubbing of the skin
  • Wear smooth cotton clothes and innerwear
  • Use only mild perfumes, soaps, and detergents
  • Drink lots of water or fluids

How can Plasma Cell Balanitis be Prevented?

  • Currently, there are no specific methods or guidelines to prevent Plasma Cell Balanitis
  • Practice good personal hygiene, which can help prevent infections and the condition from getting worse
  • A careful and periodic monitoring or follow-up of the condition is recommended

What is the Prognosis of Plasma Cell Balanitis? (Outcomes/Resolutions)

  • Plasma Cell Balanitis is a rare, benign (non-cancerous) condition that has an excellent prognosis with appropriate treatment
  • It is important to educate individuals that the condition is not a sexually-transmitted infection and allay their anxieties and fears

Additional and Relevant Useful Information for Plasma Cell Balanitis:

  • A differential diagnosis may be considered to eliminate the following conditions:
    • Psoriasis
    • Allergic contact dermatitis     
    • Lichen planus
    • Squamous cell carcinoma in situ
    • Fixed drug eruption
    • Syphilis

There is no evidence to prove that dietary factors have an influence on Plasma Cell Balanitis.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Oct. 2, 2015
Last updated: Dec. 23, 2018