A Case of Pseudoepitheliomatous Keratotic and Micaceous Balanitis with Verrucous Carcinoma

Abstract

Pseudoepitheliomatous Keratotic and Micaceous Balanitis (PKMB) is a rare chronic inflammatory disease characterised by hardened, hyperkeratotic plaques on the glans of the penis of older men. Although PKMB is described as benign, there is growing evidence that it has the potential to become cancerous. authors hereby report a case of 55 year old male who was initially characterised by white sclerosis and atrophy at the glans. Without treatment, verrucous keratinising organisms appeared after two years and were misdiagnosed as viral warts. The patient received four cryotherapy treatment with liquid nitrogen, which completely removed the warts, but the rash recurred about two months after cryotherapy. The patient received histopathological examinations which showed obvious hyperkeratosis with incomplete keratosis in the epidermis, papilloma-like and pseudoepithelioma-like hyperplasia appeared in the spinous layer, flattening of rete ridges, squeezing growth into the dermis, disordered arrangement of basal cells and frequent mitoses. A few squamous masses were seen in the dermis and the formation of squamous fossa could be seen.There were more lymphocyte infiltrations in the superficial layer of the dermis and around blood vessels. After being diagnosed with PKMB with verrucous carcinoma, the patient finally chose to undergo surgery in the Urology Department of another hospital. Unfortunately, we lost the follow-up. Our case supports the view that PKMB can develop into a malignant disease, which suggests that early detection, treatment and follow-up of the disease are essential.