BASIC/CLINICAL SCIENCE Plasma Cell Balanitis: Clinicopathologic Study of 112 Cases and Treatment Modalities Bhushan Kumar, Tarun Narang, Bishan Dass Radotra, and Somesh Gupta Background : Plasma cell balanitis or Zoon’s balanitis is an idiopathic benign condition of the genitalia that mostly presents as a solitary, persistent plaque on the glans primarily in uncircumcised, middle-aged to older men. Methods : One hundred twelve patients with a clinical diagnosis of plasma cell balanitis were studied between January 1985 and April 2003. Results : The age of the patients ranged from 24 to 70 years. The majority of patients had symptoms for more than 12 months. Lesions involved the prepuce and glans in the majority of patients (66; 58.92%), the prepuce only in 26 patients (23.21%), and the glans only in 20 patients (17.85%). Tissue for histopathology was available in 96 patients. Histologically, epidermal edema, a dense upper dermal band of chronic inflammatory cells, including many plasma cells, dilated capillaries, extravasated red blood cells, and hemosiderin deposition, was seen. In most, cases, plasma cell balanitis was successfully treated by circumcision. Conclusions : This report describes our experience with plasma cell balanitis and reviews its clinical and histopathologic aspects. The treatment modalities are also reviewed, and the importance of circumcision as the treatment of choice is emphasized. Ant e ´ c e ´ dents : La balanite a ` plasmocytes ou balanite de Zoon est une condition idiopathique be ´ nigne des organes ge ´ nitaux qui se pre ´ sente souvent sous forme de plaque solitaire persistante sur le gland d’hommes d’a ˆ ge moyen a ` avance ´ qui ne sont pas circoncis. Me ´thodes: On a e ´ tudie ´ le cas de 112 patients ayant rec ¸ u un diagnostic de balanite a ` plasmocytes entre janvier 1985 et avril 2003. Re ´sultats: Les patients e ´ taient a ˆ ge ´s de 24 a ` 70 ans. La majorite ´ avait des sympto ˆ mes pendant plus de 12 mois. Les le ´ sions touchaient le pre ´ puce et le gland chez la plupart des patients, soit 66 patients (58,92 %), le pre ´ puce seul chez 26 patients (23,21 %), et le gland seul chez 20 patients (17,85 %). On a pu re ´ cupe ´ rer du tissu pour l’histopathologie chez 96 patients. L’examen histologique a re ´ ve ´ le ´ un œde ` me e ´ pidermique, une bande e ´ paisse supe ´ rieure forme ´ e de cellules inflammatoires chroniques, notamment d’un grand nombre de plasmocytes, des capillaires dilate ´ s, des globules rouges extravase ´ s ainsi que des de ´ po ˆ ts d’he ´ moside ´ rine. Dans la plupart des cas, la balanite a ` plasmocytes a e ´ te ´ traite ´ e gra ˆ ce a ` une circoncision. Conclusions : Ce rapport de ´ crit notre expe ´ rience avec la balanite a ` plasmocytes et donne un aperc ¸ u de ses aspects cliniques et histopathologiques. Les modalite ´ s de traitement ont e ´ te ´ revues et l’importance de la circoncision comme traitement de choix a e ´ te ´ souligne ´ e. P LASMA CELL BALANITIS (PCB) or balanitis circum- scripta plasmacellularis is a benign, idiopathic con- dition first recognized by Zoon in 1952. 1 PCB typically presents as a solitary, smooth, shiny, red-orange plaque of the glans and prepuce of uncircumcised, middle-aged to older men. 2–4 The disease tends to be chronic and may persist for months to years. The characteristic histologic features are a band-like inflammatory infiltrate that is mainly plasmacytic in the upper dermis, dilated capillaries, and deposition of hemosiderin. Topical pharmacotherapy is useful in the early stages to reduce the initial symptoms and slow down the progression but is not effective in all cases and is not curative. Circumcision, which was advo- cated as the best modality of treatment many decades ago, 5 still remains the preferred treatment. 6–9 This report describes our experience with PCB and reviews its clinico- pathologic aspects and treatment modalities. Patients and Methods Patients attending the sexually transmitted disease clinic at our center between January 1985 and April 2003 who fulfilled the clinical criteria of PCB (Table 1) were included From the Department of Dermatology, Venereology and Leprology and the Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Address reprint requests to: Bhushan Kumar, MD, MNAMS, Department of Dermatology, Venereology and Leprology, PGIMER, Chandigarh 160 012, India; E-mail: kumarbhushan@hotmail.com. DOI 10.1007/7140.2006.00008 Journal of Cutaneous Medicine and Surgery, Vol 10, No 1 (January/February), 2006: pp 11–15 11