Balanoposthitis: Difference between revisions

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*Etiology
*Etiology
**Irritant, bacterial, or fungal
**Irritant, bacterial, or fungal
*Recurrent balanoposthitis can be sole presenting sign of DM
*Recurrent balanoposthitis can be sole presenting sign of diabetes mellitus


==Diagnosis==
==Diagnosis==
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**Sitz baths BID-TID while inflammation persists
**Sitz baths BID-TID while inflammation persists
**Hygiene
**Hygiene
***Clean between foreskin and glans w/ Q-tip and irrigate w/ water until resolves
***Clean between foreskin and glans with Q-tip and irrigate with water until resolves
***Once resolved regular bathing of area in water (no soap) should be sufficient
***Once resolved regular bathing of area in water (no soap) should be sufficient
*Bacterial
*Bacterial
**Topical triple abx ointment QID or mupirocin cream BID
**Topical triple antibiotic ointment QID or mupirocin cream BID
*Fungal
*Fungal
**Topical antifungal agents BID x2wk
**Topical antifungal agent BID x 2wk
***Clotrimazole 1% cream, miconazole 2% cream (may combine w/ hydrocortisone cream)
***Clotrimazole 1% cream, miconazole 2% cream (may combine w/ hydrocortisone cream)
***Nystatin cream 100,000 units/gm if infection is resistant
***Nystatin cream 100,000 units/gm if infection is resistant
**Single PO dose of fluconazole may be used in pts with DM or severe infection
**Single PO dose of fluconazole may be used in patient with diabetes mellitus or severe infection


==Disposition==
==Disposition==

Revision as of 18:06, 26 August 2013

Background

  • Balanitis = cellulitis of the glans
  • Posthitis = cellulitis of the foreskin
  • Risk factors:
    • Poor hygiene
    • Phimosis
  • Etiology
    • Irritant, bacterial, or fungal
  • Recurrent balanoposthitis can be sole presenting sign of diabetes mellitus

Diagnosis

  • Glans, foreskin are swollen, tender, and edematous
  • Erythematous papular rash with satellite lesions = fungal

Treatment

  • Irritant
    • Sitz baths BID-TID while inflammation persists
    • Hygiene
      • Clean between foreskin and glans with Q-tip and irrigate with water until resolves
      • Once resolved regular bathing of area in water (no soap) should be sufficient
  • Bacterial
    • Topical triple antibiotic ointment QID or mupirocin cream BID
  • Fungal
    • Topical antifungal agent BID x 2wk
      • Clotrimazole 1% cream, miconazole 2% cream (may combine w/ hydrocortisone cream)
      • Nystatin cream 100,000 units/gm if infection is resistant
    • Single PO dose of fluconazole may be used in patient with diabetes mellitus or severe infection

Disposition

Discharge

See Also

Paraphimosis Reduction

Source

UpToDate, Tintinalli