balanitis plasmocellularis

Last reviewed 01/2018

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)


  • 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)


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