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Balanitis
is inflammation of the glans penis; posthitis is inflammation of
the prepuce; and balanoposthitis is inflammation of both.
Inflammation of the head of the penis may be a complication of candidiasis, gonococcal or chlamydial urethritis, chancroid, trichomoniasis, herpes simplex, scabies, or primary or secondary syphilis. Noninfectious causes include reactive arthritis (formerly, Reiter's syndrome), which can produce shallow, painless ulcers of the glans (balanitis circinata); fixed drug eruptions; contact dermatitis; psoriasis; lichen planus; seborrheic dermatitis; balanitis xerotica obliterans; and erythroplasia of Queyrat. Often, no cause can be found. Balanoposthitis often occurs in patients with a tight prepuce (phimosis), which interferes with adequate hygiene. The subpreputial secretions may become infected with anaerobic bacteria, resulting in inflammation. Diabetes mellitus predisposes to balanoposthitis. Isolated balanitis occurs mainly in circumcised patients.
Soreness, irritation, and a subpreputial discharge often occur 2 or 3 days after sexual intercourse. Phimosis, superficial ulcerations, and inguinal adenopathy may follow.
The conditions listed above, especially candidiasis, should be investigated and the urine tested for glucose. The patient's skin should be examined for lesions that suggest genital involvement with a dermatosis. History should include investigation of latex condom use. Nonspecific hygienic measures should be instituted and specific causes treated. Subpreputial irrigation to remove secretions and detritus may be necessary. Once inflammation has resolved, circumcision or preputial plasty should be considered in patients with persistent phimosis.
Last full review/revision November 2005
Content last modified November 2005
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