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Plasma cell balanitis/vulvitis
What is plasma cell balanitis/vulvitis?
This uncommon skin condition usually presents as red patches on the genitals. It is called plasma cell balanitis
in men and plasma cell vulvitis
in women because of the numerous plasma cells seen on skin biopsy. A plasma cell is a type of white blood cell found in some inflammatory conditions.
Plasma cell balanitis affects the head of the penis (the glans) and is also known as balanitis circumscripta plasmacellularis or Zoon balanitis. Plasma cell vulvitis is most commonly found on the inside of the vulva at the entrance to the vagina (vestibule). It is also known as vulvitis circumscripta plasmacellularis.
What are the signs and symptoms of plasma cell balanitis/vulvitis?
In males, the lesion is usually a single glistening red plaque. In women there are usually several patches. Patients may have no symptoms but they may complain of tenderness and/or slight itchiness.
Images of plasma cell balanitis/vulvitis
What causes plasma cell balanitis/vulvitis?
The finding of plasma cells in the biopsy may be quite non-specific and may be a reactive response to an infection, irritation or injury. Several cases diagnosed originally as plasma cell balanitis/vulvitis turn out later to be other skin diseases such as an infection, allergic contact dermatitis, psoriasis, lichen planus or penile or vulvar intraepithelial neoplasia.
The cause of plasma cell balanitis/vulvitis is unknown. It is not a sexually transmitted disease and is not caused by human papilloma virus. In males, it is more common in uncircumcised middle-aged to older men: the area under the foreskin is warm and moist, ideal conditions for the growth of organisms.
Diagnosis of plasma cell balanitis/vulvitis
This condition can look similar to other skin conditions affecting the penis or the vulva. A skin biopsy of the area may be recommended by the dermatologist to help with diagnosis.
Management of plasma cell balanitis/vulvitis
A topical steroid cream can be useful in some cases. Other treatments reported to be of benefit in some cases include:
- Topical antibiotics
- Topical antifungal agents
- Topical calcineurin inhibitors such as tacrolimus ointment or pimecrolimus cream
- Imiquimod cream
- Surgical excision, electrosurgery or laser destruction. Circumcision is recommended for plasma cell balanitis and may result in cure.
Related information
Self-help books
- The V Book: A Doctor's Guide to Complete Vulvovaginal Health
- The Vulvodynia Survival Guide: How to Overcome Painful Vaginal Symptoms & Enjoy an Active Lifestyle
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On DermNet NZ:
Other websites:
- Balanitis Circumscripta Plasmacellularis – emedicine dermatology, the online textbook