Balanoposthitis

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 DM

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 w/ Q-tip and irrigate w/ water until resolves
    • Once resolved regular bathing of area in water (no soap) should be sufficient
• Bacterial
  • Topical triple abx ointment QID or mupirocin cream BID
• Fungal
  • Topical antifungal agents BID x2wk
    • 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 pts with DM or severe infection

Disposition

Discharge

Source

UpToDate, Tintinalli