Balanitis

Balanitis, balanoposthitis occur very often together. These are very common inflammations on the penis (balanitis) and foreskin (posthitis).

Etiology

  • Infectious: as candidal infection on the basis of diabetes mellitus.
  • Allergic and irritating: caused by insufficient or excessive hygiene, certain cosmetic products or sexual aids.

A predisposing factor is the foreskin extending beyond the glans penis.

Clinical picture

  1. Balanoposthitis simplex: as circumscribed erythema, edema of the glans penis and prepuce. The foreskin may even fill with secretions. The etiology is most often irritant. Collar-shaped scales and yellowish pustules, itching and burning may also appear, then a yeast infection is suspected.
  2. Balanoposthitis erosiva et gangraenosa: in mixed anaerobic infection, when up to gangrene occurs.
  3. Balanitis circinata: as polycyclic red map-like erosions. They accompany Reiter's syndrome.
  4. Balanitis plasmocellularis Zoon: as sharply demarcated shiny erythema with punctate petechiae. It occurs after the age of 50.

Diagnosis

The diagnosis is different according to the etiology:

  • culture is necessary for infectious etiology,
  • contact allergy is confirmed by an epicutaneous testy,
  • in case of chronicity, we confirm the diagnosis with a biopsy, thanks to which we also rule out possible neoplasia morbus Queyrat.

Differential diagnosis

When erosions occur, we consider herpes simplex, ulcer venereal diseases, drug exanthema, Queyrat erythroplasia.

Therapy

The basis of treatment is to find out the etiology. Baths in an antiseptic (hypermanganese) or physiological solution are often used. Can be used externally with antibiotics, antimycotics, corticoids. Breathable, light dosage forms (creams, solutions) are more suitable. Systemic treatment is rarely used.

Course and Prognosis

Mostly good. In the case of chronic balanoposthitis, however, it is a risk factor for penile cancer.

References

  • ŠTORK, Jiří. Dermatovenereology. 1. edition. Galen, Karolinum, 2008. 502 pp. ISBN 978-80-7262-371-6.