BACKGROUND: Pseudoepitheliomatous, keratotic, and micaceous balanitis (PKMB) is an extremely rare condition occurring over the glans in older men who undergo circumcision late in life. Its exact etiology is unknown. OBJECTIVES: We report a patient with PKMB that involved the meatus and led to urinary obstruction. METHODS: A 57-year-old, circumcised man presented with partial urinary obstruction caused by a thick, nail-like covering on the skin of his glans penis. Based on histology, PKMB was diagnosed. There was no cytological atypia. The patient was treated successfully with topical 5-aminolevulinic acid (ALA) photodynamic therapy (PDT). RESULTS: There was no recurrence after 18 months of follow-up. Treatment with ALA-PDT seems to be effective and well tolerated in PKMB. CONCLUSIONS: This case indicates that ALA-PDT may be an effective treatment option for plaque-stage PKMB and thus warrants further investigation.
BACKGROUND: Pseudoepitheliomatous, keratotic, and micaceous balanitis (PKMB) is an extremely rare condition occurring over the glans in older men who undergo circumcision late in life. Its exact etiology is unknown. OBJECTIVES: We report a patient with PKMB that involved the meatus and led to urinary obstruction. METHODS: A 57-year-old, circumcised man presented with partial urinary obstruction caused by a thick, nail-like covering on the skin of his glans penis. Based on histology, PKMB was diagnosed. There was no cytological atypia. The patient was treated successfully with topical 5-aminolevulinic acid (ALA) photodynamic therapy (PDT). RESULTS: There was no recurrence after 18 months of follow-up. Treatment with ALA-PDT seems to be effective and well tolerated in PKMB. CONCLUSIONS: This case indicates that ALA-PDT may be an effective treatment option for plaque-stage PKMB and thus warrants further investigation.