Pseudoepitheliomatous, keratotic and micaceous balanitis: A case report

Abstract

Sir, Pseudoepitheliomatous, keratotic, and micaceous balanitis (PKMB) is an uncommon premalignant and rare condition occurring over the glans in older men who undergo circumcision late in life [1]. It was first described in 1961 by Lortat-Jacob and Civatte, who described it as locally advancing thick hyperkeratotic plaque on the glans penis [2]. It was previously thought a benign condition, but is now believed to be premalignant [3]. Herein, We report a patient with PKMB who, having declined definitive surgery was managed with cryotherapy and lifelong followup. A 52 year old circumcised male patient presented at the dermatology departement with a 1 year history of gradually enlarging thick scaly plaque on the glans penis. There was no history of itching, or difficulty in urination. He was an ex-smoker. Patient was non diabetic and there was no history suggestive of sexually transmitted infections. There was no history of bleeding either spontaneously or following minor trauma. He was not taking any medication. He was treated with antiseptic applications and herbal medicines on various occasions. Examination revealed a thick scaly plaque on the glans penis measuring about 2 cm by 2 cm (Fig. 1). The plaque was not tender or itchy, and was not obstructing the urethral meatus. The rest of the genitalia were normal.