|Year : 2018 | Volume
| Issue : 10 | Page : 1253-1254
Candida Balanitis with Hyperplastic Plaque Mimicking Vascular Neoplasm
Xue-Yan Yao1, Xiao-Bin Zhou1, Wen-Ge Zhang1, Bo-Yang Liu2, Guang-Dong Wen1, Jian-Zhong Zhang1, Cheng Zhou1
1 Department of Dermatology, Peking University People's Hospital, Beijing 100044, China
2 Department of Family Practice, University of British Columbia, Grand Forks, British Columbia V0H 1H0, Canada
|Date of Submission||28-Jan-2018|
|Date of Web Publication||30-Apr-2018|
Dr. Cheng Zhou
Department of Dermatology, Peking University People's Hospital, No. 11 of Xi Zhi Men South Street, Beijing 100044
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Yao XY, Zhou XB, Zhang WG, Liu BY, Wen GD, Zhang JZ, Zhou C. Candida Balanitis with Hyperplastic Plaque Mimicking Vascular Neoplasm. Chin Med J 2018;131:1253-4
|How to cite this URL:|
Yao XY, Zhou XB, Zhang WG, Liu BY, Wen GD, Zhang JZ, Zhou C. Candida Balanitis with Hyperplastic Plaque Mimicking Vascular Neoplasm. Chin Med J [serial online] 2018 [cited 2018 Aug 21];131:1253-4. Available from: http://www.cmj.org/text.asp?2018/131/10/1253/231514
To the Editor: A 61-year-old diabetic male presented with a growing hyperplastic plaque measured 1.5 cm × 1.0 cm on the glans of his penis for 2 months [Figure 1]a. The plaque was pruritic burning. Polarized dermoscopy revealed multiple red papules with whitish areas of erosions [Figure 1]b. The patient was diagnosed as vascular neoplasm at other hospitals and he came to the Department of Dermatology, Peking University People's Hospital for further consultation before an excision surgery.
|Figure 1: A 61-year-old diabetic male diagnosed as candida balanitis with hyperplastic plaque. (a) A growing hyperplastic plaque measured 1.5 cm × 1.0 cm on the glans of the penis. (b) Polarized dermoscopy revealed multiple red papules nodules with whitish areas of erosions (×30). Histologically, pseudoepitheliomatous hyperplasia of the epidermis, dilation and proliferation of the vascular vessels, swelling of vascular endothelium in the dermis with erythrocytes extravasation, and hemosiderin were observed. Dense mixed infiltration of plasma cells, neutrophils, and eosinophils were noted in the dermis (HE staining; c: ×100; d: ×200). (e) Direct microscopic examination of fungi by fluorescent staining obviously showed growth of fungal hyphae (× 400).|
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Histopathological examination showed epidermal pseudoepitheliomatous hyperplasia, dilation and proliferation of the vascular vessels with edematous vascular endothelium, erythrocytes extravasation and deposits of hemosiderin; dense mixed infiltration of plasma cells, neutrophils, and eosinophils were noted in the dermis [Figure 1]c and [Figure 1]d. Periodic acid-Schiff and Grocott's methenamine silver staining were negative for fungus. The results of Treponema pallidum particle assay, rapid plasma reagin test, and antibodies to human immunodeficiency virus, hepatitis B virus, and hepatitis C virus were all negative. Smears and culture for fungus were positive for candida under fluorescence microscopy [Figure 1]e.
After an empiric treatment of oral itraconazole 200 mg once daily for 2 weeks, the lesions flattened and shrunk dramatically. This was followed by complete resolution of the lesion with some hyperpigmentation of the skin after 5 weeks. The patient was finally diagnosed as candida balanitis with hyperplastic plaque.
Balanitis, inflammation of the glans penis, is a frequently presenting genital disorder. Infection, especially candida infection, is a common cause of balanitis. Candida balanitis and balanoposthitis are usually characterized by blotchy erythema with small papules which may be eroded or dry dull red areas with a glazed appearance. As we have known so far, the lesions of hyperplastic angiomatoid plaque had not been reported in candida balanitis. Obviously, before making the diagnosis of candida balanitis with hyperplastic plaque, other causes of balanitis or neoplasms with hyperplastic plaques need to be excluded, including but not limited to lichen planus, syphilis, Zoon's balanitis, psoriasis, circinate balanitis, erythroplasia of Queyrat, and squamous cell carcinoma.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent form. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
This work was supported by grants from the National Natural Science Foundation of China (No. 81773311 and No. 81402588).
Conflicts of interest
There are no conflicts of interest.
| References|| |
Edwards SK; European Branch of the International Union against Sexually Transmitted Infection and the European Office of the World Health Organization. European guideline for the management of balanoposthitis. Int J STD AIDS 2001;12 Suppl 3:68-72. doi: 10.1258/0956462011923976.