Presentations may be similar, but treatment differs
Because the treatments for Zoon’s balanitis and erythroplasia of Queyrat are different, a biopsy is imperative. Erythroplasia of Queyrat is a premalignant condition that is treated with topical fluorouracil or surgical excision.3 Treatment for Zoon’s balanitis consists of a topical corticosteroid with or without topical anticandidal agents and circumcision after the acute inflammation resolves.1,2 (If a skin biopsy cannot be obtained in the clinic, the foreskin [if affected] can be sent for biopsy after the circumcision.)
If resolution is not seen with topical steroid treatment, other treatments have demonstrated efficacy. These include topical tacrolimus, as well as YAG and carbon dioxide laser treatments.4-6
Although information is limited on rates of recurrence, circumcision is considered the treatment of choice and is usually curative.1
Ointment does the trick for our patient
Our patient was treated with a single combined topical ointment consisting of nystatin and triamcinolone cream with zinc oxide. The lesion resolved completely after 10 days. We requested a urology consult so that a circumcision could be performed.
CORRESPONDENCE Matthew R. Noss, DO, MSEd, Fort Belvoir Community Hospital Family Medicine Clinic, 1st Floor, Eagle Pavilion, 9300 Dewitt Loop, Ft. Belvoir, VA 22060; mnoss@vcom.vt.edu