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


==Overview==
==[[Balanitis historical perspective|Historical Perspective]]==
'''Balanitis''' is [[inflammation]] of the [[glans penis]] (from [[Greek language|Greek]]: βάλανος ''balanos'' "acorn"). When the foreskin (or prepuce) is also affected, it is termed ''[[balanoposthitis]]''.


Lack of aeration and irritation because of [[smegma]] and discharge surrounding the glans penis causes inflammation and edema.
==[[Balanitis pathophysiology|Pathophysiology]]==
==Classification==


===Zoon's Balanitis===
==[[Balanitis causes|Causes]]==
'''Zoon's balanitis''' also known as ''Balanitis Circumscripta Plasmacellularis'' or ''plasma cell balanitis'' (PCB) is an idiopathic, rare, benign penile dermatosis (Keogh, 2005) for which circumcision is often the preferred treatment (Pellice, 1999; Buechner, 2002; Keogh, 2005). Zoon's balanitis has been successfully treated with the carbon dioxide laser (Baldwin, 1989) and more recently Albertini and colleagues report the avoidance of circumcision and successful treatment of Zoon's balanitis with an Er:YAG laser (Albertini, 2002). Another study, by Retamar and colleagues, found that 40 percent of those treated with CO<sub>2</sub> laser relapsed (Retamar, 2003).


===Circinate Balanitis===
==[[Balanitis differential diagnosis|Differentiating Balanitis from other Diseases]]==
'''Circinate balantitis''' (also known as '''balanitis circinata''') is a serpiginous annular dermatitis associated with[[Reiter's syndrome]].
==Causes==
Inflammation has many possible causes, including irritation by environmental substances, physical trauma, and infection by a wide variety of pathogens, including bacteria, virus, or fungus &mdash; each of which require a particular treatment (Edwards, 1996).
===Circumcision===
Some studies indicate balanitis to be more common in uncircumcised boys (Fergusson, 1988; Herzog, 1986; Fakjian, 1990; Leber, 2005; Waskett, 2005), but Van Howe found balanitis only in circumcised boys (Van Howe, 1997). Van Howe's study has been criticised for the fact that few boys were uncircumcised (Waskett, 2005).


===Genital Washing===
==[[Balanitis epidemiology and demographics|Epidemiology and Demographics]]==
Many studies of balanitis do not examine the subjects' genital washing habits. However, O'Farrell ''et al.'' report that failure to wash the whole penis, including retraction of the foreskin in uncircumcised men, is more common among balanitis sufferers (O'Farrell, 2005). Birley ''et al.'', however,  found that ''excessive'' genital washing with soap may be a strong contributing factor to balanitis (Birley, 1993).
==Epidemiology and Demographics==
===Prevalence===
Escala and Rickwood, in a 1989 examination of 100 cases of balanitis in childhood, concluded that the risk "in any individual, uncircumcised boy appears to be no greater than 4%." (Escala, 1989).  Øster reported no balanitis in 9545 observations of uncircumcised Danish boys (Oster, 1968). Balanitis in boys still in nappies must be distinguished from the normal redness seen in boys caused by ammoniacal dermatitis (Simpson, 1998).


While any man can develop balanitis, the condition is most likely to occur in men who have a tight foreskin that is difficult to pull back, or who have poor hygiene. Diabetes can make balanitis more likely, especially if the blood sugar is poorly controlled.
==[[Balanitis risk factors|Risk Factors]]==


==Natural History, Complications and Prognosis==
==[[Balanitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


===Complications===
==Diagnosis==
[[Balanitis history and symptoms|History and Symptoms]] | [[Balanitis physical examination|Physical Examination]] | [[Balanitis laboratory findings|Laboratory Findings]] | [[Balanitis other imaging findings|Other Imaging Findings]] | [[Balanitis other diagnostic studies|Other Diagnostic Studies]]


Balanitis may cause oedema (Chow), resulting in [[phimosis]], or inability to retract the foreskin from the glans penis. Adherence of the foreskin to the inflamed and edematous glans penis is the cause (Leber, 2005; Chow; Edwards, 1996).
==Treatment==
 
[[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]]
==Diagnosis==
Diagnosis may include careful identification of the cause with the aid of a good patient history, swabs and cultures, and pathologic examination of a biopsy (Edwards, 1996).


==External Links==
== Case Studies ==
*Balanitis - [http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10515.html InteliHealth]
[[Balanitis case study one|Case #1]]
*Zoon's Balanitis - [http://www.emedicine.com/derm/topic45.htm InteliHealth]
*Edwards S. (for the Clinical Effectiveness Group) [http://www.bashh.org/guidelines/2002/balanitis_0901b.pdf National guideline on the management of balanitis]. Association for Genitourinary Medicine (UK) and the Medical Society for the Study of Venereal Diseases (UK), 2001.
==Related Chapters==
==Related Chapters==
*[[Penis]]
*[[Penis]]

Revision as of 20:19, 20 March 2013

Template:DiseaseDisorder infobox For patient information, click here

Balanitis Microchapters

Patient Information

Overview

Classification

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

Causes

Differential Diagnosis

Steven C. Campbell, M.D., Ph.D.

Synonyms and keywords: Balanoposthitis

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Balanitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

References

  1. Edwards S. Balanitis and balanoposthitis: a review. Genitourin Med 1996;72(3):155-9
  2. Leber M. Balanitis. (online). eMedicine.com. Cited 20 Aug 2005
  3. Chow KW. Balanitis and other genital conditions. In: Social Hygiene Handbook. Hong Kong.
  4. Escala JM, Rickwood AMK. Balanitis. Brit J Urol 1989;63:196-7
  5. Øster J. Further fate of the foreskin: incidence of preputial adhesions, phimosis, and smegma among Danish Schoolboys. Arch Dis Child 1968;43:200-3
  6. Simpson ET, Barraclough P. The management of the paediatric foreskin. Aust Fam Physician 1998;27(5):381-3
  7. Fergusson DM, Lawton JM, Shannon FT. Neonatal circumcision and penile problems: an 8-year longitudinal study. Pediatrics 1988;81(4):537-41
  8. Herzog LW, Alvarez SR. The frequency of foreskin problems in uncircumcised children. Am J Dis Child 1986; 140: 254-256
  9. Fakjian N, Hunter S, Cole GW, Miller J. An argument for circumcision. Prevention of balanitis in the adult. Arch Dermatol 1990 Aug;126(8):1046-7.
  10. Waskett JH. Balanitis and the uncircumcised male. Pediatrics. P3R Response (12 Jun 2005)
  11. Van Howe RS. Variability in penile appearance and penile findings: a prospective study. Brit J Urol 1997;80:776-782
  12. Birley HDL, Luzzi GA, Bell R. Clinical features and management of recurrent balanitis: association with atopy and genital washing. Genitourin Med 1993;69(5):400-3
  13. Pellice i Vilalta C, Casalots i Casado J, Cosme i Jimenez MA. Zoon's balanoposthitis. A preliminary note. Arch Esp Urol 1999 Jan-Feb;52(1):69-72
  14. Buechner SA. Common skin disorders of the penis. BJU Int 2002 Sep;90(5):498-506.
  15. Keogh G. Balanitis circumscripta plasmacellularis. (online). eMedicine.com. Cited 20 Aug 2005
  16. Baldwin HE, Geronemus RG. The treatment of Zoon's balanitis with the carbon dioxide laser. J Dermatol Surg Oncol 1989 May;15(5):491-4
  17. Albertini JG, Holck DE, Farley MF. Zoon's balanitis treated with Erbium:YAG laser ablation. Lasers Surg Med 2002; 30(2):123-6
  18. Retamar RA, Kien MC, Chouela EN. Zoon's balanitis: presentation of 15 patients, five treated with a carbon dioxide laser. Int J Dermatol 2003 Apr;42(4):305-7
  19. O'Farrell N, Quigley M, Fox P. 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.

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