Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
Indian J Sex Transm Dis
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Year : 2010  |  Volume : 31  |  Issue : 1  |  Page : 63-64

What is your diagnosis?

Department of Dermatology, Venereology and Leprology, G R Medical College, Gwalior, India

Date of Web Publication3-Sep-2010

Correspondence Address:
Khozema Saify
Multispecialty Clinic, In basement of Parakh X-ray, Kampoo, Lashkar, Gwalior - 474 001 (MP)
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0253-7184.69010

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How to cite this article:
Saify K, Saraswat P K, Mishra D, Jeswani P. What is your diagnosis?. Indian J Sex Transm Dis 2010;31:63-4

How to cite this URL:
Saify K, Saraswat P K, Mishra D, Jeswani P. What is your diagnosis?. Indian J Sex Transm Dis [serial online] 2010 [cited 2023 Nov 30];31:63-4. Available from:

A 60-year-old uncircumcised male presented with asymptomatic growth on the glans penis of 7 years duration. There were no complaints or past history suggestive of sexually transmitted diseases (STDs). There was no history of trauma to penis, localized dermatoses, systemic diseases or any prolonged medications. There was no history of any significant illness in the partner. The condition was initially diagnosed clinically as a case of penile psoriasis and treated with potent topical corticosteroids. There was partial response to the treatment with some reduction in scaling, but the patch gradually increased in size and became elevated over the course of time. Over the past 1 year, the lesion started increasing in the size, developed verrucosity and thick mica-like scaling. On examination, there was hyperkeratotic, hypertrophic, verrucous plaque with thick scaling on the glans and rim of erythema. His S. VDRL and S. HIV tests were normal. Hematological, biochemical and radiological examination did not reveal any abnormality. Histopathological examination with hematoxylin and eosin staining showed irregular exo-endophytic hyperplasia of the epidermis with elongated downgrowths. There was prominent mitotic activity of the basal and suprabasal layers of the epidermis with mild atypia and pleomorphism of nuclei. The surface showed a marked thick, parakeratotic stratum corneum. A focally lichenoid lymphoplasmacytic infiltrate was present [Figure 1] and [Figure 2].
Figure 1 :Hyperkeratotic plaques on the glans penis

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Figure 2 :Erythema of the dorsal surface of the penis

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What is your diagnosis?

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   References Top

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2.Bart RS, Kopf AW. Tumor Conference No 14: on a dilemma of penile horns-pseudoepitheliomatous, hyperkeratotic and micaceous balanitis. J Surg Oncol 1977;3:580.  Back to cited text no. 2      
3.Krunic AL, Djerdj K, Starcevic-Bozovic A, Kozomara MM, Martinovic NM, Vesic SA et al. Pseudoepitheliomatous, keratotic and micaceous balanitis. Case report and review of the literature. Urol Int 1996;56:125-8.  Back to cited text no. 3      
4.Jenkins D Jr, Jakubovic HR. Pseudoepitheliomatous, keratotic, micaceous balanitis. A clinical lesion with two histological subsets: hyperplastic dystrophy and verrucous carcinoma. J Am Acad Dermatol 1988;18:419-22.  Back to cited text no. 4  [PUBMED]    
5.Bunker CB, Neill SM, Rook's Textbook of Dermatology. 7 th ed. Oxford: Blackwell Science; 2004. p. 68, 35.  Back to cited text no. 5      
6.Child FJ, Kim BK, Ganesan R, Southern SA, Herrington CS, Calonje E. Verrucous carcinoma arising in Pseudoepitheliomatous keratotic and micaceous balanitis, without evidence of human papilloma virus. Br J Dermatol 2000;143:183-7.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]  
7.Beljaards RC, van Dijk E, Hausman R. Is Pseudoepitheliomatous, micaceous and keratotic balanitis synonymous with verrucous carcinoma? Br J Dermatol 1987;117:641-6.  Back to cited text no. 7  [PUBMED]    
8.Irvine C, Anderson JR, Pye RJ. Micaceous and keratotic Pseudoepitheliomatous balanitis and rapidly fatal fibrosrcoma of the penis occurring in the same patient. Br J Dermatol 1987;116:719-25.  Back to cited text no. 8  [PUBMED]    
9.Querol NI, Cordoba IA, Castillo Jimeno JM, Ripa SL, Monzon Munoz FJ. Pseudoepitheliomatous and micaceous balanitis. Arch Esp Urol 1998;51:824-6.  Back to cited text no. 9      
10.Bargman H. Pseudoepitheliomatous, keratotic, and micaceous balanitis. Cutis 1985;35:77-9.  Back to cited text no. 10  [PUBMED]    
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  [Figure 1], [Figure 2]


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