BALANITIS AND BALANOPOSTHITIS
Definition
Balanitis is inflammation of the glans penis. Posthitis is inflammation of the foreskin. The term balanoposthitis may be used when both occur but the term balanitis is commonly used.
Clinical features and investigation
Poor hygiene and a tight prepuce predispose to infectious causes of balanitis by organisms such as С albicans, streptococci, anaerobic bacteria, herpes simplex, N gonorrhoeae and T vaginalis.
Balanitis may be part of a systemic disorder such as Reiter’s disease, Stevens-Johnson syndrome or Behcet’s syndrome or be due to noninfectious cutaneous pathology including balanitis xerotica obliterans, fixed drug eruption or erythroplasia of Queyrat (a premalignant condition). Differential diagnosis includes Kaposi’s sarcoma of the glans.
Swelling and purulent discharge from beneath the prepuce are the early features of balanitis. Inguinal lymphadenopathy may occur. The condition may lead to partial phimosis.
Microbiological examination for yeasts, bacteria and trichomonads should be done. Diabetes mellitus should be excluded.
Management
Cleaning of the affected area with normal saline should be instituted while awaiting the results of microbiological tests.
Candidiasis should be treated by local application of an antifungal agent (nystatin, clotrimazole or miconazole cream applied twice daily).
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