Balanoposthitis: Difference between revisions
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*Balanitis = inflammation of the glans | *Balanitis = inflammation of the glans | ||
*Posthitis = inflammation of the foreskin | *Posthitis = inflammation of the foreskin | ||
*Balanoposthitis = inflammation of both glans and foreskin | |||
*Recurrent balanoposthitis can be sole presenting sign of [[diabetes mellitus]] | *Recurrent balanoposthitis can be sole presenting sign of [[diabetes mellitus]] | ||
===Risk factors=== | ===Risk factors=== | ||
*Poor hygiene | *Poor hygiene | ||
*Lack of circumcision | |||
*[[Diabetes]] | *[[Diabetes]] | ||
*Immunodeficiency | |||
*[[Phimosis]] | *[[Phimosis]] | ||
===Etiology=== | ===Etiology=== | ||
*Fungal (most common overall, [[candida]] most common species)<ref>McCollough M, Rose E. Genitourinary and renal tract disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 173.</ref> | *Fungal (most common overall, [[candida]] most common species)<ref>McCollough M, Rose E. Genitourinary and renal tract disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 173.</ref> | ||
*Irritant | *Irritant (soaps, lotions, lubricants) | ||
*Bacterial | *Bacterial, which includes common skin organisms (Staph, strep) and STIs. | ||
*Trauma | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC3150172 ijgm-4-511f1.png|thumb|Candidal balanoposthitis in a diabetic]] | [[File:PMC3150172 ijgm-4-511f1.png|thumb|Candidal balanoposthitis in a diabetic]] | ||
*Glans | *Glans and foreskin may be swollen, erythematous, tender, or itchy | ||
*Severe cases may involve difficulty voiding, foul smell, and penile discharge/purulence | |||
*Erythematous papular [[rash]] with satellite lesions = fungal | *Erythematous papular [[rash]] with satellite lesions = fungal | ||
==Differential Diagnosis== | |||
{{Nontrauma penile DDX}} | |||
{{Penile Trauma DDX}} | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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*Typically a clinical diagnosis | *Typically a clinical diagnosis | ||
*Consider blood glucose measurement to evaluate for diabetes | *Consider blood glucose measurement to evaluate for diabetes | ||
*Consider swabbing for [[Sexually transmitted diseases]] in the appropriate setting | |||
==Management== | ==Management== | ||
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*Hygiene | *Hygiene | ||
**Clean between foreskin and glans with Q-tip and irrigate with water until resolves | **Clean between foreskin and glans with Q-tip and irrigate with water until resolves | ||
**Once resolved regular bathing of area in water | **Once resolved regular bathing of area in water is sufficient; soap may worsen irritation | ||
===Antimicrobial=== | ===Antimicrobial=== | ||
{{Balanoposthitis Antimicrobial}} | {{Balanoposthitis Antimicrobial}} | ||
Revision as of 16:36, 7 November 2025
Background
- Balanitis = inflammation of the glans
- Posthitis = inflammation of the foreskin
- Balanoposthitis = inflammation of both glans and foreskin
- Recurrent balanoposthitis can be sole presenting sign of diabetes mellitus
Risk factors
Etiology
- Fungal (most common overall, candida most common species)[1]
- Irritant (soaps, lotions, lubricants)
- Bacterial, which includes common skin organisms (Staph, strep) and STIs.
- Trauma
Clinical Features
- Glans and foreskin may be swollen, erythematous, tender, or itchy
- Severe cases may involve difficulty voiding, foul smell, and penile discharge/purulence
- Erythematous papular rash with satellite lesions = fungal
Differential Diagnosis
Non-Traumatic penile diagnoses
Penile trauma types
Differential Diagnosis
Non-Traumatic penile diagnoses
Penile trauma types
Evaluation
- Typically a clinical diagnosis
- Consider blood glucose measurement to evaluate for diabetes
- Consider swabbing for Sexually transmitted diseases in the appropriate setting
Management
Reduce Irritation
- Sitz baths BID-TID while inflammation persists
- Hygiene
- Clean between foreskin and glans with Q-tip and irrigate with water until resolves
- Once resolved regular bathing of area in water is sufficient; soap may worsen irritation
Antimicrobial
Common organisms are Candida, anaerobes, and Group B Streptococcus
Antifungal
- Clotrimazole 1% applied topically to glans q12hrs until resolution
- Nystatin cream 100,000 units/gm if infection is recurrent after clotrimazole therapy
Antibacterial
- Topical triple antibiotic ointment QID or mupirocin cream BID
Disposition
- Discharge
See Also
References
- ↑ McCollough M, Rose E. Genitourinary and renal tract disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 173.
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