Document Detail

Differentiation between balanitis and carcinoma in situ using reflectance confocal microscopy.
MedLine Citation:
PMID:  23325422     Owner:  NLM     Status:  MEDLINE    
IMPORTANCE: Zoon plasma cell balanitis is a benign inflammatory disease of genital skin. It may be difficult to clinically distinguish between balanitis and carcinoma in situ (CIS); thus, a biopsy may be needed to exclude malignant disease. Reflectance confocal microscopy (RCM) is an in vivo imaging method to get morphologic information about architecture and single cells in the skin.
OBJECTIVE: To evaluate the ability of RCM to differentiate between balanitis and CIS compared with the gold standard histopathologic methods.
DESIGN: Observer blinded study.
SETTING: A referral center.
PARTICIPANTS: Fifteen patients with balanitis or CIS.
INTERVENTION: Patients were assessed by clinical, histologic, and RCM findings. All lesions were imaged with the Vivascope 1500. In 5 cases of balanitis, the surrounding, noninvolved skin also was evaluated.
MAIN OUTCOME MEASURES: Local recurrence, nodal metastasis, disease-specific death, overall death.
RESULTS: The clinical diagnoses showed 9 cases of balanitis and 6 cases of CIS. With histopathologic analysis, 12 cases of balanitis and cases of CIS were diagnosed, and RCM evaluation confirmed these diagnoses. The most relevant RCM criteria for CIS were atypical honeycomb pattern, disarranged epidermal pattern, and round nucleated cells. Balanitis showed a nucleated honeycomb pattern and vermicular vessels. Scattered small bright cells and round vessels were present in all lesions. The adjacent normal skin showed a typical honeycomb pattern and round papillary vessels.
CONCLUSIONS AND RELEVANCE: We were able to differentiate between balanitis and CIS. Reflectance confocal microscopy may help to avoid biopsies at this sensitive site.
Edith Arzberger; Peter Komericki; Verena Ahlgrimm-Siess; Cesare Massone; Dmitry Chubisov; Rainer Hofmann-Wellenhof
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JAMA dermatology     Volume:  149     ISSN:  2168-6084     ISO Abbreviation:  JAMA Dermatol     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-06-11     Completed Date:  2013-07-30     Revised Date:  2013-12-13    
Medline Journal Info:
Nlm Unique ID:  101589530     Medline TA:  JAMA Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  440-5     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Balanitis / diagnosis*
Carcinoma in Situ / diagnosis*
Diagnosis, Differential
Foreskin / pathology*
Microscopy, Confocal / methods*
Middle Aged
Penile Neoplasms / diagnosis*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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