The cause of balanitis plasmacellularis is unknown however heat friction and rubbing are possible contributing factors.

A similar condition has been described in women (i.e. "Zoon's vulvitis"),[3] although its existence is controversial due to the possibility of diagnostic error in many of the cases that have been reported in the medical literature.

On the other hand, symptoms including pruritus, dysuria, discomfort, and a burning sensation may occasionally accompany it.

[5] Balanitis plasmacellularis appears as one or more orange-red, glossy, moist, glistening, well-circumscribed, macular to slightly elevated plaque(s).

Due to microhemorrhage and hemosiderin deposition, there may be several pinpoint, brighter red spots scattered across the orange-red plaque's backdrop.

[4] Since it primarily affects uncircumcised men, discomfort from urine retention and smegma in the setting of "dysfunctional prepuce" is assumed to be the cause, which can result in poor genital hygiene and recurrent local infections.

A dense inflammatory infiltrate of mostly plasma cells beneath the epidermis and an increase in vertically oriented capillaries are possible additional pathogenic signs.

Zoon dubbed this ailment "balanoposthite chronique circonscrite bénigne á plasmocytes" or "balanitis chronica circumscripta plasmacellularis" and regarded it as a separate entity because all of these patients shared identical histological findings.