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{{DiseaseDisorder infobox |
  Name          = Balanitis |
  Image          = Balanitis.jpg|
  Caption        = Balanitis Xerotica Obliterans; White Lesions <br> <small> [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology] </small>|
}}
'''For patient information, click [[Balanitis (patient information)|here]]'''
{{Balanitis}}
{{Balanitis}}
{{SCC}}
{{CMG}}; {{AE}}{{VD}}


{{SK}} Balanoposthitis
{{SK}} Balanoposthitis
==[[Balanitis overview|Overview]]==


==[[Balanitis historical perspective|Historical Perspective]]==


==[[Balanitis classification|Classification]]==
==Overview==
Balanitis is [[inflammation]] of [[glans penis]]. When inflammation involves the [[foreskin]] and [[prepuce]], it is termed as [[balanoposthitis]]. Based on the etiology, balanitis can be mainly categorized into [[Infectious balanitis|infectious]], [[inflammatory dermatoses]], and [[penile carcinoma in situ]]. Patients with [[balanitis]] may present with asymptomatic or symptomatic lesions with [[itch]] or [[pain]] in the genital region. [[Risk factors]], [[pathogenesis]], clinical presentation, [[diagnosis]] and management varies from [[etiology]] to [[etiology]].


== Classification  ==


==[[Balanitis pathophysiology|Pathophysiology]]==
There is no established classification system for Balantis. Based on the etiologies, Balanitis can be classified into:<ref name="pmid24828553">{{cite journal| author=Edwards SK, Bunker CB, Ziller F, van der Meijden WI| title=2013 European guideline for the management of balanoposthitis. | journal=Int J STD AIDS | year= 2014 | volume= 25 | issue= 9 | pages= 615-26 | pmid=24828553 | doi=10.1177/0956462414533099 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24828553  }}</ref>
* [[Infectious balanitis|Infectious]]
* Non-infectious balanitis
:*[[Zoon's balanitis]]
:*[[Balanitis xerotica obliterans]]


==[[Balanitis causes|Causes]]==
== Causes ==


==[[Balanitis differential diagnosis|Differentiating Balanitis from other Diseases]]==
=== '''Infectious balanitis''' ===
'''Common causes of infectious balanitis''' 


==[[Balanitis epidemiology and demographics|Epidemiology and Demographics]]==
'''Fungal'''
* [[Candida]] (most common cause)
'''Protozoal'''
* [[Trichomonas vaginalis]]
'''spirochaetes'''
* [[Treponema pallidum]]
'''Viral'''
* [[Herpes simplex]]
* [[Human papillomavirus|Human papilloma virus]]  


==[[Balanitis risk factors|Risk Factors]]==
==== Less common causes of infectious balanitis ====
'''Fungal'''
* [[Dermatophytosis]] 
* [[Pityriasis versicolor]]
* [[Histoplasma capsulatum]]
* [[Blastomyces dermatitidis]]
* [[Cryptococcus neoformans]]


==[[Balanitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
==== Viral ====
* [[Varicella zoster virus|Varicella zoster virus (VZV)]]


==Diagnosis==
==== Protozoal ====
[[Balanitis history and symptoms|History and Symptoms]] | [[Balanitis physical examination|Physical Examination]] | [[Balanitis laboratory findings|Laboratory Findings]] | [[Balanitis ultrasound|Ultrasound]] | [[Balanitis other imaging findings|Other Imaging Findings]] | [[Balanitis other diagnostic studies|Other Diagnostic Studies]]
* [[Entamoeba histolytica]]
* [[Leishmania|Leishmania species]]


==== Parasitic ====
* [[Sarcoptes scabiei]]
* [[Pediculosis]]
* [[Ancylostoma]]


==Treatment==
==== Bacterial ====
[[Balanitis medical therapy|Medical Therapy]] | [[Balanitis surgery|Surgery]] | [[Balanitis primary prevention|Primary Prevention]] | [[Balanitis secondary prevention|Secondary Prevention]] | [[Balanitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Balanitis future or investigational therapies|Future or Investigational Therapies]]
'''Gram negative bacteria'''
* [[Escherichia coli|E.coli]]
* [[Pseudomonas]]
* [[Haemophilus|Haemophilus parainfluenzae]]
* [[Klebsiella]]
* [[Neisseria gonorrhoeae|Neisseria gonorrhoea]]
* [[Haemophilus ducreyi]]
* [[Mycoplasma genitalium]]
* [[Chlamydia]]
* [[Ureaplasma]]
* [[Gardnerella vaginalis]]
* [[Citrobacter]]
* [[Enterobacter]]


== Case Studies ==
==== Spirochaetes ====
[[Balanitis case study one|Case #1]]
* Non-specific [[spirochaetal]] [[infection]]
==Related Chapters==
'''Gram positive organism'''
*[[Penis]]
* [[Streptococci|Haemolytic Streptococci(Group B Streptococci)]]
*[[Glans penis]]
* [[Staphylococci|Staphylococci epidermidis/aureus]]
*[[Foreskin]]
'''Acid fast bacilli'''
*[[Inflammation]]
* [[Mycobacterium tuberculosis]]
*[[Circumcision]]
* [[Mycobacterium leprae]]  
*[[Balanitis xerotica obliterans]]


==References==
==== Anaerobes ====
{{refbegin|2}}
* [[Bacteroides]]  
# Edwards S. [http://www.circs.org/library/edwards/ Balanitis and balanoposthitis: a review]. ''Genitourin Med'' 1996;72(3):155-9
# Leber M. [http://www.emedicine.com/emerg/topic51.htm Balanitis]. (online). eMedicine.com. Cited 20 Aug 2005
# Chow KW. [http://www.cirp.org/library/disease/balanitis/chow/ Balanitis and other genital conditions]. In: ''Social Hygiene Handbook''. Hong Kong.
# Escala JM, Rickwood AMK. [http://www.cirp.org/library/disease/balanitis/escala1/ Balanitis]. ''Brit J Urol'' 1989;63:196-7
# Øster J. [http://www.cirp.org/library/general/oster/ Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish Schoolboys]. ''Arch Dis Child'' 1968;43:200-3
# Simpson ET, Barraclough P. [http://www.cirp.org/library/hygiene/simpson1/ The management of the paediatric foreskin]. ''Aust Fam Physician'' 1998;27(5):381-3
# Fergusson DM, Lawton JM, Shannon FT. [http://www.circs.org/library/fergusson/ Neonatal circumcision and penile problems: an 8-year longitudinal study]. ''Pediatrics'' 1988;81(4):537-41
# Herzog LW, Alvarez SR. [http://www.circs.org/library/herzog/ The frequency of foreskin problems in uncircumcised children]. Am J Dis Child 1986; 140: 254-256
# Fakjian N, Hunter S, Cole GW, Miller J. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2383029 An argument for circumcision. Prevention of balanitis in the adult]. ''Arch Dermatol'' 1990 Aug;126(8):1046-7.
# Waskett JH. [http://pediatrics.aappublications.org/cgi/eletters/81/4/537#1382 Balanitis and the uncircumcised male]. Pediatrics. P3R Response (12 Jun 2005)
# Van Howe RS. [http://www.cirp.org/library/complications/vanhowe/ Variability in penile appearance and penile findings: a prospective study]. ''Brit J Urol'' 1997;80:776-782
# Birley HDL, Luzzi GA, Bell R. [http://www.cirp.org/library/disease/balanitis/birley/ Clinical features and management of recurrent balanitis: association with atopy and genital washing]. ''Genitourin Med'' 1993;69(5):400-3
# Pellice i Vilalta C, Casalots i Casado J, Cosme i Jimenez MA. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10101891&dopt=Abstract Zoon's balanoposthitis. A preliminary note]. ''Arch Esp Urol'' 1999 Jan-Feb;52(1):69-72
# Buechner SA. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12175386 Common skin disorders of the penis]. ''BJU Int'' 2002 Sep;90(5):498-506.
# Keogh G. [http://www.emedicine.com/derm/topic45.htm Balanitis circumscripta plasmacellularis]. (online). eMedicine.com. Cited 20 Aug 2005
# Baldwin HE, Geronemus RG. [http://www.cirp.org/library/disease/balanitis/baldwin1/ The treatment of Zoon's balanitis with the carbon dioxide laser]. ''J Dermatol Surg Oncol'' 1989 May;15(5):491-4
# Albertini JG, Holck DE, Farley MF. [http://www.cirp.org/library/disease/balanitis/albertini1/ Zoon's balanitis treated with Erbium:YAG laser ablation]. ''Lasers Surg Med'' 2002; 30(2):123-6
# Retamar RA, Kien MC, Chouela EN. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12694501 Zoon's balanitis: presentation of 15 patients, five treated with a carbon dioxide laser]. ''Int J Dermatol'' 2003 Apr;42(4):305-7
# O'Farrell N, Quigley M, Fox P. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16105191&query_hl=21 Association between the intact foreskin and inferior standards of male genital hygiene behaviour: a cross-sectional study]. ''Int J STD AIDS'' 2005 Aug;16(8):556-9.
{{refend}}


{{Diseases of the pelvis, genitals and breasts}}
=== '''Non-infectious balanitis''' ===


[[de:Eichelentzündung]]
==== Inflammatory dermatoses conditions causing balanitis ====
[[es:Balanitis]]
* [[Lichen sclerosus]]
[[fr:Balanite]]
* [[Lichen planus]]
[[it:Balanite]]
* [[Zoon's balanitis]]
[[ms:Balanitis]]
* [[Psoriasis]]
[[nl:Balanitis]]
* [[Reiter's Disease|Circinate balanitis]]
[[fi:Terskatulehdus]]
* [[Eczema]]  
[[sv:Balanit]]
* [[Seborrhoeic dermatitis]]
* [[Fixed drug eruption]]
* Non-specific [[balanoposthitis]]
'''Penile carcinoma in situ causing balanitis'''
* [[Bowenoid papulosis]]
* [[Erythroplasia of Queyrat]]
* [[Bowen's disease]]


= Differential Diagnosis =
{| class="wikitable"
! colspan="3" |Symptoms
! colspan="4" |Signs
|-
!
!Malaise
!Pruritus
!Skin lesions
!Regional lymphadenopathy
!Erythema
!Swelling
|-
|[[Candidiasis|Candida balanitis]]
| -
| +
|[[Erythematous]] [[Rash (patient information)|rash]] with soreness and/or [[itch]]
| +
| +
| -
|-
|[[Trichomonas vaginalis]]
| -
| +
|Superficial erosive [[balanitis]] 
| -
| +
| -
|-
|[[Treponema pallidum]]
| -
| -
|Multiple circinate lesions
| +
| -
| -
|-
|[[Herpes simplex]]
| +
| +
|Grouped [[vesicles]] on [[erythematous]] base
| +
| +
| -
|-
|[[Human papillomavirus|Human papilloma virus]]
| -
| +
|[[Warts]]
| -
| -
| -
|-
|[[Lichen sclerosus]]
| -
| +
|White patches on [[glans]]
| -
| -
| -
|-
|[[Lichen planus]]
| -
| +
|Purplish [[lesions]] on the [[penis]]
| -
| -
| -
|-
|[[Psoriasis]]
| -
| +
|Red scaly [[plaques]]
| -
| +
| -
|-
|[[Reiter's Syndrome|Circinate]]
| +
| +
|Greyish white areas on the [[glans]]
| -
| -
| -
|-
|[[Zoon's balanitis]]
| -
| +
|Well-circumscribed orange-red glazed areas
| -
| -
| -
|-
|[[Eczema]]
| -
| +
|Mild non-specific [[erythema]] to wide spread [[edema]] of [[penis]].
| -
| +
| +
|-
|[[Fixed drug eruption]]
| -
| +
|Well demarcated and [[Erythema|erythematous]] lesions
| -
| +
| -
|-
|[[Bowen's disease]]
| -
| +
|Multiple, small, well-demarcated [[Papillomatosis|papillomatous]] [[papules]]
| -
| -
| -
|-
|[[Bowenoid papulosis]]
| -
| +
|Single or multiple, sharply demarcated associated with [[Scaling skin|scaling]] and crusting
| -
| -
| -
|-
|[[Erythroplasia of Queyrat]]
| -
| +
|Velvety patches and [[plaques]] of [[keratinization]] on [[penis]].
| +
| -
| -
|}


[[Category:Circumcision debate]]
== References ==
[[Category:Inflammations]]
{{Reflist|2}}
[[Category:Urology]]
[[Category:Penis]]
[[Category:Signs and symptoms]]
[[Category:Primary care]]
 
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Latest revision as of 20:35, 29 July 2020

Balanitis Microchapters

Patient Information

Overview

Classification

Infectious balanitis
Non-infectious balanitits
Zoon's balanitis
Balanitis xerotica obliterans

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]

Synonyms and keywords: Balanoposthitis


Overview

Balanitis is inflammation of glans penis. When inflammation involves the foreskin and prepuce, it is termed as balanoposthitis. Based on the etiology, balanitis can be mainly categorized into infectious, inflammatory dermatoses, and penile carcinoma in situ. Patients with balanitis may present with asymptomatic or symptomatic lesions with itch or pain in the genital region. Risk factors, pathogenesis, clinical presentation, diagnosis and management varies from etiology to etiology.

Classification

There is no established classification system for Balantis. Based on the etiologies, Balanitis can be classified into:[1]

Causes

Infectious balanitis

Common causes of infectious balanitis

Fungal

Protozoal

spirochaetes

Viral

Less common causes of infectious balanitis

Fungal

Viral

Protozoal

Parasitic

Bacterial

Gram negative bacteria

Spirochaetes

Gram positive organism

Acid fast bacilli

Anaerobes

Non-infectious balanitis

Inflammatory dermatoses conditions causing balanitis

Penile carcinoma in situ causing balanitis

Differential Diagnosis

Symptoms Signs
Malaise Pruritus Skin lesions Regional lymphadenopathy Erythema Swelling
Candida balanitis - + Erythematous rash with soreness and/or itch + + -
Trichomonas vaginalis - + Superficial erosive balanitis  - + -
Treponema pallidum - - Multiple circinate lesions + - -
Herpes simplex + + Grouped vesicles on erythematous base + + -
Human papilloma virus - + Warts - - -
Lichen sclerosus - + White patches on glans - - -
Lichen planus - + Purplish lesions on the penis - - -
Psoriasis - + Red scaly plaques - + -
Circinate + + Greyish white areas on the glans - - -
Zoon's balanitis - + Well-circumscribed orange-red glazed areas - - -
Eczema - + Mild non-specific erythema to wide spread edema of penis. - + +
Fixed drug eruption - + Well demarcated and erythematous lesions - + -
Bowen's disease - + Multiple, small, well-demarcated papillomatous papules - - -
Bowenoid papulosis - + Single or multiple, sharply demarcated associated with scaling and crusting - - -
Erythroplasia of Queyrat - + Velvety patches and plaques of keratinization on penis. + - -

References

  1. ↑ Edwards SK, Bunker CB, Ziller F, van der Meijden WI (2014). "2013 European guideline for the management of balanoposthitis". Int J STD AIDS. 25 (9): 615–26. doi:10.1177/0956462414533099. PMID 24828553.

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