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Pseudoepitheliomatous keratotic and micaceous balanitis pathology

Author: Adjunct A/Prof Patrick Emanuel, Dermatopathologist, Clínica Ricardo Palma, Lima, Peru. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley. October 2018. 


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Introduction

Pseudoepitheliomatous keratotic and micaceous balanitis is a coronal balanitis that gradually takes on a silvery white appearance due to mica-like crusts and keratotic horny masses on the glans.

Histology of pseudoepitheliomatous keratotic and micaceous balanitis

In pseudoepitheliomatous keratotic and micaceous balanitis, the histology shows acanthosis, hyperkeratosis and pseudoepitheliomatous hyperplasia with no cytological atypia (figures 1–3). There are non-specific dermal infiltrates.

Pseudoepitheliomatous keratotic and micaceous balanitis pathology

Special studies for pseudoepitheliomatous keratotic and micaceous balanitis

A PAS stain is useful to exclude a fungal infection.

Differential diagnosis for pseudoepitheliomatous keratotic and micaceous balanitis

Other diagnoses to be considered include:

  • Squamous cell carcinoma — this shows cytologic atypia. A biopsy is often needed to rule out dysplasia or carcinoma.

 

References

  • Subudhi C L, Singh P C. Pseudoepitheliomatous, keratotic and micaceous balanitis producing nail-like lesion on the glans penis. Indian J Dermatol Venereol Leprol [serial online] 1999 [cited 2018 Oct 13];65:75–7. Available from: http://www.ijdvl.com/text.asp?1999/65/2/75/4765

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