A recurrent rash on the penis: Plasma cell balanitis (or Zoon’s balanitis) with BXO

Plasma cell balanitis (or Zoon’s balanitis) can be associated with genital lichen sclerosus.

Zoon Balanitis with male genital lichen sclerosus (called Balanitis Xerotica Obliterans ) which was usually cured by circumcision

You can try following before circumcision:

1. Patients might initially be tried by GP with good genital hygiene

2. Protective ointments which helps to prevent the irritants

3. Avoiding contact with constant dripping of urine

4. Topical corticosteroids like Betnovate 0.1% or (alone or with antibacterial or antifungal agents like Clobetasone butyrate 0.05% with nystatin and oxytetracyline cream).

5. Potent topical corticosteroids like Clobetasol are also the first line treatment for genital lichen sclerosus.

6. Ask to refer patients with any non-responsive, suspicious, persistent, or atypical penile lesions to a specialist.

7. Consider biopsy if the diagnosis is uncertain or BXO

8. Complete cure is most likely with circumcision in case of Zoon Balanitis with BXO

Ref:  https://doi.org/10.1136/bmj.n1666 (Published 10 July 2020)

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