Pseudoepitheliomatous Hyperplasia

A 78-year-old man presented with an asymptomatic, irregular lesion on the right side of the glans penis. The 0.5-cm, light purple injected, finely papular lesion had spontaneously erupted about 2 months earlier.

An incisional biopsy was performed by Robert P. Blereau, MD of Morgan City, La. Examination of a specimen showed pseudoepitheliomatous hyperplasia with prominent dermal acute and chronic inflammation, focal extravasation of red blood cells, scattered eosinophils, dermal fibrosis, and focal microabscess formation. Scattered intraepithelial acute inflammation and parakeratosis were also noted. There was no evidence of malignancy; all special stains for organisms were negative.

Pseudoepitheliomatous hyperplasia is a histologic reaction pattern with irregular hyperplasia of the epidermis that occurs as a response to a wide variety of stimuli, such as trauma, cryotherapy, chronic lymphedema, and chronic irritation which arises around urostomy and colostomy sites. Other causative factors are various dermal inflammatory processes that include chromomycosis, sporotrichosis, pyodermas, and actinomycosis.

Because these lesions can enlarge or ulcerate, excision may be considered; however, this patient's redundant prepuce would make it difficult to remove the lesion. Since the cause of this patient's condition could not be identified, no treatment was offered. The patient will be followed up regularly.

FOR MORE INFORMATION:

• Weedon D. Skin Pathology. Edinburgh: Churchill Livingstone; 1997:637.