Balanitis Flashcards
What is balanitis?
Inflammation of the glans penis, sometimes extending to the underside of the foreskin which is known as balanoposthitis.
What are the causes of balanitis?
Most common - bacterial and candidal or aautoimmune causes.
Acute or chronic
Candidiasis Dermatitis (contact, allergic, eczema, psoriasis) Bacterial Anaerobic Lichen planus Lichen sclerosus Plasma cell blanitis of zoon Circinate blanitis
What is the general treatment of balanitis?
Hygiene (washing under the foreskin) - Gentle saline washes
1% Hydrocortisone
Stretching the foreskin
What makes up the assessment of balanitis?
Clinical diagnosis - history and examination
Acute or chronic presentation
History - eczema, psoriasis, connective tissue diseases
How can balanitis caused by candidiasis present?
Very common, acute
Usually occurs after intercourse and associated with itching and white non-urethral discharge
How can balanitis caused by dermatitis (contact/allergic) present?
Acute, common
Itchy, sometimes painful and occasionally associated with a clear non-urethral discharge. Often there is no other body area affected.
How can balanitis caused by dermatitis (eczema or psoriasis) present?
Acute/chronic, common
Very itchy but not associated with any discharge and there will be a medical history of an inflammatory skin condition with active areas elsewhere on the body
How can balanitis caused bacteria present?
Common, acute
Painful, can be itchy with yellow non-urethral discharge and most often due to Staphylococcs spp.
How can balanitis caused by anaerobic bacteira present?
Common, acute
May be itchy but is most associated with a very offensive yellow non-urethral discharge
How can balanitis caused by lichen planus present?
Uncommon, acute/chronic
May be itchy, the main diagnostic feature is the presence of Wickham’s striae and violaceous papules
How can balanitis caused by lichen sclerosus present?
Rare, chronic
May be itchy, associated with white plaques and can cause significant scarring
How can balanitis caused by plasma cell balanitis of zoon present?
Rare, chronic
Not itchy with clearly circumscribes areas of inflammation
How can balanitis caused by circinate balanitis present?
Uncommon, acute/chronic
Not itchy and not associated with any discharge. The key feature is painless erosions, it can be associated with reactive arthritis
What are the investigations of balanitis?
Clinical diagnosis
Swab for microscopy and culture
Biopsy (extensive skin changes)
What is the specific treatment of balanitis caused by candidiasis?
Topical clotrimazole (2 weeks)
