'Watering-can penis' in pseudoepitheliomatous, keratotic and micaceous balanitis.

Sir, Pseudoepitheliomatous, keratotic and micaceous balanitis (PKMB) is a rare, acquired disease of elderly men mainly involving the glans penis. It is characterized by progressive thick crusts and sheets of mica-like scales often leading to phimosis. It was first described by Lortat-Jacob and Civatte in 1961 (1). The exact aetiology is unknown. The histological features include acanthosis, gross hyperkeratosis and hyperplasia with irregular downward extensions, with infiltration of chronic inflammatory cells (2 – 5). Once assumed to be a benign condition, there is now growing evidence that it should be viewed as a premalignant condition or a locally invasive low-grade malignant lesion (2 – 5). We report a case of PKMB with the unusual involvement of the urethral meatus leading to urinary obstruction and physical disability as regards sexual function.