Zoon's balanitis

This condition presents as:

• shiny, moist, erythematous, well-dermacated plaque on the glans penis in an older uncircumcised male
  • well-demarcated, moist, shiny, bright-red or autumn-brown multiple pinpoint patches involve the glans and prepuce - “cayenne pepper spots” (1)
• presentation is often indolent and asymptomatic
• differential diagnosis includes seborrhoeic dermatitis,erosive lichen planus, psoriasis, fixed drug eruption, secondary syphilis, erythroplasia of Queyrat and Kaposi's sarcoma

Biopsy is often indicated (2)

Treatment

• may improve with altered washing habits plus intermittent application of a mild or potent topical corticosteroid (with or without antibiotics and anticandidal drugs)
  • often persists or relapses
• almost all cases occur in uncircumcised men and nearly all are cured by circumcision
• alternative methods – CO2 laser (1)

Notes:

• some believe that Zoon's balanitis indicates a dysfunctional foreskin (1)

Reference:

• (1) British Association for Sexual Health and HIV. 2008 UK National Guideline on the Management of Balanoposthitis
• (2) Bunker C B. Male genital dermatology. London: Saunders, 2004.