Balanitis

Etymology

The word balanitis is from the Greek βάλανος* balanos*, literally meaning 'acorn' because of the similarity in shape to the glans penis. -Itis is a suffix from the Greek for 'inflammation'. Posthe is the Greek word meaning 'foreskin'.

Signs and symptoms

• Small red erosions on the glans (first sign)
• Redness of the foreskin
• Redness of the penis
• Other rashes on the head of the penis
• Foul-smelling discharge
• Painful foreskin and penis

Complications

Recurrent bouts of balanitis may cause scarring of the preputial orifice; the reduced elasticity may lead to pathologic phimosis. Further complications may include:

• Stricture of urinary meatus
• Paraphimosis

Causes

Inflammation has many possible causes, including irritation by environmental substances, certain medications, physical trauma, and infection such as bacterial, viral, or fungal. Some of these infections are sexually transmitted, however a yeast infection, Candida balanitis, is generally not categorized as such.

It is less common among males who are circumcised; in many cases, a dysfunction of the foreskin is a causal or contributing factor. Both not enough cleaning and too much cleaning can cause problems.

Diagnosis

Diagnosis may include careful identification of the cause with the aid of a good patient history, swabs and cultures, and pathological examination of a biopsy.

Types

• Zoon's balanitis, also known as Balanitis Circumscripta Plasmacellularis or plasma cell balanitis (PCB), is an idiopathic, rare, benign penile dermatosis for which circumcision is often the preferred treatment. Zoon's balanitis has been successfully treated with the carbon dioxide laser; and more recently, Albertini and colleagues report the avoidance of circumcision and successful treatment of Zoon's balanitis with an Er:YAG laser. Another study, by Retamar and colleagues, found that 40 percent of those treated with CO2 laser relapsed.
• Circinate balanitis, also known as balanitis circinata, is a serpiginous annular dermatitis associated with reactive arthritis.
• Pseudoepitheliomatous keratotic and micaceous balanitis

Treatment

Initial treatment in adults often involves simply pulling back the foreskin and cleaning the penis. However, some topical antibiotic and fungal ointments may be used for treatment for mild cases. Depending upon severity, hydrocortisone and other steroidal creams may be used upon consultation.

Epidemiology

Balanitis "is a common condition affecting 11% of adult men seen in urology clinics and 3% of children" in the United States; globally, balanitis "may occur in up to 3% of uncircumcised males".

Other animals

In dogs, balanoposthitis is caused by a disruption in the integumentary system, such as a wound or intrusion of a foreign body. A dog with this condition behaves normally, with the exception of excessive licking at the prepuce, and a yellow green, pus-like discharge is usually present.

In sheep (rams/wethers), ulcerative enzootic balanoposthitis is caused by the Corynebacterium renale group (C. renale, C. pilosum & C. cystidis).

For the condition in bulls, caused by a virus see Bovine herpesvirus 1.

Balanoposthitis is believed to have contributed to the decline to near-extinction of the marsupial Gilbert's potoroo.

References

References

1. (1998). "The management of the paediatric foreskin". Aust Fam Physician.
2. {{LSJ. ba/lanos. βάλανος. ref.
3. {{EMedicine. article. 777539. Phimosis
4. "Balanitis".
5. Edwards S. (1996). "Balanitis and balanoposthitis: a review". Genitourin Med.
6. [http://my.clevelandclinic.org/disorders/penile_disorders/hic_disorders_of_the_penis.aspx Cleveland Clinic: Penile Disorders]
7. (August 2014). "2013 European guideline for the management of balanoposthitis.". International Journal of STD & AIDS.
8. Keogh G. {{eMedicine. derm. 45. Balanitis circumscripta plasmacellularis
9. (1999). "[Zoon's balanoposthitis. A preliminary note]". Arch. Esp. Urol..
10. Buechner SA. (2002). "Common skin disorders of the penis". BJU Int..
11. (1989). "The treatment of Zoon's balanitis with the carbon dioxide laser". The Journal of Dermatologic Surgery and Oncology.
12. (2002). "Zoon's balanitis treated with Erbium:YAG laser ablation". Lasers Surg Med.
13. (2003). "Zoon's balanitis: presentation of 15 patients, five treated with a carbon dioxide laser". Int. J. Dermatol..
14. {{EMedicine. article. 777026. Balanitis
15. (2011). "Balanoposthitis, Dyspareunia, and Treponema in the Critically Endangered Gilbert's Potoroo (''Potorous gilbertii'')". Journal of Wildlife Diseases.