Case history
Case history #1
A 55-year-old man presents with a 5-year history of itching and burning of the glans penis and 'tightness' of the foreskin. He reports discomfort and occasional tearing of the foreskin during sexual intercourse. On examination, he has symmetrical, white, atrophic patches with telangiectasia on the glans penis, meatal stenosis, and a tight, inflamed foreskin. The cause of the balanoposthitis is lichen sclerosus.
Case history #2
A 60-year-old uncircumcised man presents with a 1-year history of a persistent red, ovoid lesion on his glans penis. It is usually asymptomatic but occasionally sore. He is troubled by the appearance and worried he has picked up an infection or a malignancy. STI screens were negative. Clinically, there was a well-demarcated, red, just slightly raised, eccentric plaque, and the overlying foreskin showed a non-specific posthitis. The clinical differential diagnosis included Zoon balanitis, lichen planus, and erythroplasia of Queyrat. A biopsy was taken and showed full-thickness undifferentiated carcinoma in situ/penile intraepithelial neoplasia associated with human papillomavirus infection.
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