A rare case report of pseudoepitheliomatous keratotic and micaceous balanitis

Pseudoepitheliomatous keratotic and micaceous balanitis (PKMB) is a rare chronic penile dermatosis that typically affects elderly men and carries a potential risk of malignant transformation. We report a case of a 59-year-old previously healthy male who presented with a 3-year history of a slowly progressive, mildly painful growth on the glans penis. He had a history of balanitis for which circumcision had been performed. Clinical examination revealed a well-defined hyperkeratotic plaque with adherent hyperkeratotic scaling over the glans penis, giving a horn-like appearance, without ulceration or inguinal lymphadenopathy. 
Histopathological examination demonstrated marked hyperkeratosis, parakeratosis, and pseudoepithelio-matous hyperplasia of the epidermis, negative for dysplasia and malignancy. The patient is currently receiving treatment with fortnightly cryotherapy and three times per week application of 5-Fluorouracil (5-FU). This case highlights the importance of early recognition and histopathological confirmation of this rare premalignant condition to guide appropriate management and prevent progression to malignancy.