Pseudoepitheliomatous keratotic and micaceous balanitis in an adolescent: a case report

Ana I. Vasques, Unidade de Saúde Familiar Lameirinhas, Unidade Local de Saúde da Guarda, Guarda, Portugal Oscar Tellechea, Serviço de Dermatologia, Unidade Local de Saúde de Coimbra, Coimbra, Portugal Carlos Monteiro, Department of Dermatology, Hospital Sousa Martins - ULS Guarda, Lisbon, Portugal

Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB) is a rare penile dermatosis of unknown etiology, characterized clinically by thickened, hyperkeratotic plaques, often with adherent, silvery, micaceous scales on the glans penis. It is frequently mistaken for other inflammatory or neoplastic conditions. We report a case of this rare disorder in a 17-year-old male with no relevant medical history who presented with a white lesion on the balanopreputial sulcus, clinically suggestive of PKMB, and confirmed histologically after surgical excision. The patient achieved excellent clinical and cosmetic outcomes and remained recurrence-free after 2 years of follow-up. This case reports an unusual presentation of PKMB in a young patient and highlights the importance of early biopsy and appropriate treatment, given its malignant potential and reported risk of progression to verrucous or invasive squamous cell carcinoma.

Keywords: Balanitis. Penile dermatoses. Adolescent. Hyperkeratosis. Case report.