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 diabetes mellitus

Diagnosis

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

Differential Diagnosis

Non-Traumatic penile diagnoses

• Phimosis
• Balanoposthitis
• Paraphimosis
• Priapism
• STDs

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