Balanoposthitis

Background

  • Balanitis = inflammation of the glans
  • Posthitis = inflammation of the foreskin
  • Recurrent balanoposthitis can be sole presenting sign of diabetes mellitus

Risk factors

Etiology

  • Fungal (most common overall, candida most common species)[1]
  • Irritant
  • Bacterial

Clinical Features

Candidal balanoposthitis in a diabetic
  • Glans, foreskin are swollen, tender, and edematous
  • Erythematous papular rash with satellite lesions = fungal

Differential Diagnosis

Non-Traumatic penile diagnoses

Penile trauma types

Evaluation

  • Typically a clinical diagnosis
  • Consider blood glucose measurement to evaluate for diabetes

Management

Reduce Irritation

  • 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

Antimicrobial

Common organisms are Candida, anaerobes, and Group B Streptococcus

Antifungal

  • Clotrimazole 1% applied topically to glans q12hrs until resolution
  • Nystatin cream 100,000 units/gm if infection is recurrent after clotrimazole therapy

Antibacterial

  • Topical triple antibiotic ointment QID or mupirocin cream BID

Disposition

  • Discharge

See Also

Paraphimosis Reduction

References

  1. ↑ McCollough M, Rose E. Genitourinary and renal tract disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Elsevier; 2018:(Ch) 173.

UpToDate, Tintinalli

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