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Plasma Cell Balanitis Presenting in a Patient with a History of Syphilis

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Plasma cell balanitis (PCB), also knows as Zoon balanitis, is a benign asymptomatic but chronic and erosive inflammatory condition of the glans penis and prepuce that generally affects uncircumcised men in later years. Clinical presentation involves a single, shiny, well defined reddish patch. We describe the first case of PCB ever reported in a patient with a previous history of syphilis, and include a review of the current literature. A 57-year-old Hispanic man with a remote history of syphilis presented with a 6-month nonhealing, granulating ulcer of the foreskin and glans penis that had been repeatedly mistaken for syphilis and treated unsuccessfully with circumcision 3 weeks previously. Biopsy of the glans penis demonstrated sections with denuded chronic granulation tissue showing a fibrotic stroma with numerous blood vessels and a mixed inflammatory infiltrate including scattered plasma cells. It is important to differentiate PCB from a syphilitic chancre in a patient presenting with a nonhealing penile lesion. This case report demonstrates that these entities may be seen in the same patient at different times.

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No sources of funding were received to prepare this case report. The authors have no conflicts of interest to declare that are directly relevant to the content of this case report.

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Correspondence to Dr Daniel Behroozan.

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Ezra, N., Binder, S.W. & Behroozan, D. Plasma Cell Balanitis Presenting in a Patient with a History of Syphilis. Am J Clin Dermatol 13, 129–133 (2012). https://doi.org/10.2165/11593260-000000000-00000

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  • Tacrolimus
  • Syphilis
  • Pimecrolimus
  • Rapid Plasma Reagin
  • Venereal Disease Research Laboratory