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2.
WMJ ; 123(2): 144-146, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38718247

RESUMEN

A 33-year-old man presented with suprapubic abdominal pain and small vesicular lesions on the foreskin of the penis. Based on the presentation, he was empirically treated for genital herpes, although the herpes simplex virus swab was negative. He returned to the emergency department 4 months after his initial presentation with worsening symptoms that were consistent with balanoposthitis and cystitis. He was tachycardic and febrile on presentation. He denied any sexual contact for the last 3 months, with previous negative screening tests for sexually transmitted infections. Syphilis was eventually diagnosed during this admission. The incidence rates of syphilis have increased in recent years, and the infection is often undiagnosed given atypical manifestations. Here we present an atypical manifestation of syphilis that was initially misdiagnosed as herpes simplex virus.


Asunto(s)
Balanitis , Sífilis , Humanos , Masculino , Adulto , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Diagnóstico Diferencial , Balanitis/diagnóstico
3.
J Pediatr Urol ; 20(3): 480.e1-480.e6, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38461077

RESUMEN

INTRODUCTION: Balanoposthitis in boys with physiological phimosis is common. Publications on the topic are rare and literature provides no evidence-based guidelines on treatment efficacy. With this study, we aim to analyze treatments currently used, physicians' experience regarding the success and thus derive a treatment proposal. STUDY DESIGN: An online questionnaire was created to evaluate practice patterns and experience. A case scenario, open questions and multiple-choice questions were used to allow multilayered answers. Pediatricians, pediatric surgeons, pediatric urologists, and family practitioners were invited to participate. Demographic data and answers to multiple choice questions were analyzed descriptively. Free text comments were analyzed quantitively by coding the text entries and identifying relevant themes. The themes were then grouped into categories. RESULTS: Three-hundred-and-one data sets were analyzed. Predominantly, participants were from Germany and Switzerland, and most were specialized in either pediatrics or pediatric surgery. The analysis revealed a wide variability of treatments. Three main treatment forms were identified: baths, topical antiseptic treatment (wraps, gels), and topical antibiotics. Many participants use combinations of the above. Altogether, 53 treatment varieties and 27 categories were identified, including oral antibiotics and local irrigation. Treatment success was reported to be good for all treatment forms, baths were reported to be the best perceived treatment by the majority of participants. DISCUSSION: The online questionnaire generated valuable data on the wide variety of treatment used for posthitis. The fact that all treatments are reported to be highly effective suggests that little is necessary to treat the condition or that it might even be self-limiting. Further studies will be needed to prove this conclusion. Until those are available, three main concepts should be considered when choosing a treatment: avoid (traumatizing) manipulation, apply antibiotic stewardship and adhere to families' preferences and feasibility. CONCLUSION: We propose baths or local antiseptics, depending on the practitioner's and family's choice as the least invasive alternative. A prospective study to back our recommendation is scheduled.


Asunto(s)
Balanitis , Pautas de la Práctica en Medicina , Humanos , Masculino , Niño , Balanitis/terapia , Balanitis/diagnóstico , Balanitis/tratamiento farmacológico , Pautas de la Práctica en Medicina/estadística & datos numéricos , Encuestas y Cuestionarios , Antibacterianos/uso terapéutico , Antibacterianos/administración & dosificación , Fimosis/terapia , Fimosis/tratamiento farmacológico
4.
Photodiagnosis Photodyn Ther ; 46: 104066, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38552814

RESUMEN

Balanoposthitis can affect men in immunocompromised situations, such as HIV infection and diabetes. The main associated microorganism is Candida albicans, which can cause local lesions, such as the development of skin cracks associated with itching. As an alternative to conventional treatment, there is a growing interest in the photodynamic inactivation (PDI). It has been shown that the association of photosensitizers with metallic nanoparticles may improve the effectiveness of PDI via plasmonic effect. We have recently shown that the association of methylene blue (MB), a very known photosensitizer, with silver prismatic nanoplatelets (AgNPrs) improved PDI of a resistant strain of Staphylococcus aureus. To further investigate the experimental conditions involved in PDI improvement, in the present study, we studied the effect of MB concentration associated with AgNPrs exploring spectral analysis, zeta potential measurements, and biological assays, testing the conjugated system against C. albicans isolated from a resistant strain of balanoposthitis. The AgNPrs were synthesized through silver anisotropic seed growth induced by the anionic stabilizing agent poly(sodium 4-styrenesulfonate) and showed a plasmon band fully overlapping the MB absorption band. MB and AgNPrs were conjugated through electrostatic association and three different MB concentrations were tested in the nanosystems. Inactivation using red LED light (660 nm) showed a dose dependency in respect to the MB concentration in the conjugates. Using the highest MB concentration (100 µmol⋅L-1) with AgNPr, it was possible to completely inactivate the microorganisms upon a 2 min irradiation exposure. Analyzing optical changes in the conjugates we suggest that these results indicate that AgNPrs are enhancers of MB photodynamic action probably by a combined mechanism of plasmonic effect and reduction of MB dimerization. Therefore, MBAgNPrs can be considered a suitable choice to be applied in PDI of resistant microorganisms.


Asunto(s)
Candida albicans , Azul de Metileno , Fotoquimioterapia , Fármacos Fotosensibilizantes , Plata , Candida albicans/efectos de los fármacos , Azul de Metileno/farmacología , Fármacos Fotosensibilizantes/farmacología , Fotoquimioterapia/métodos , Plata/farmacología , Nanopartículas del Metal/uso terapéutico , Nanopartículas del Metal/química , Balanitis/tratamiento farmacológico , Balanitis/microbiología , Humanos
7.
Urologiia ; (6): 152-157, 2023 Dec.
Artículo en Ruso | MEDLINE | ID: mdl-38156700

RESUMEN

Balanoposthitis is a common inflammatory disease of the male genitals, which occurs more often in uncircumcised men. The cause of balanoposthitis can be an infectious, inflammatory or autoimmune process, as well as traumatization. In most cases, after proper intimate hygiene and the use of neutral moisturizers, the symptoms of balanoposthitis are completely stopped. In the case of torpid course of balanoposthitis and in the absence of improvement after drug therapy, it is necessary to exclude the malignant process. In the review article, the authors present the data of modern scientific research on the qualitative and quantitative composition of the microbiome in balanoposthitis. Differences in the composition of the microbiome were revealed in patients with balanoposthitis and healthy patients from the control group with excess foreskin. It was found that in patients with balanoposthitis, a impaired in hydration of the skin of the glans penis was revealed. Staphylococcus warneri and Prevotella bivia are the most common species associated with balanoposthitis and positively correlate with the severity of the disease. Candida infection, as an etiological factor of balanoposthitis, often occurs in children and may be associated with diaper rash. The prevalence of Gardnerella vaginalis as a pathogen in the male urogenital tract has not been fully studied. Currently, there are no reliable scientific studies that make it possible to attribute G. vaginalis to the etiological factor of balanoposthitis in men. However, it should be borne in mind that balanoposthitis may have a polymicrobial and synergistic etiology with the participation of G. vaginalis and anaerobic bacteria in the lower genital tract of men. The review article is clearly illustrated with clinical examples of the disease from the personal practice of the authors.


Asunto(s)
Balanitis , Urólogos , Niño , Humanos , Masculino , Balanitis/diagnóstico , Balanitis/tratamiento farmacológico , Balanitis/microbiología , Pene
9.
Tidsskr Nor Laegeforen ; 143(16)2023 11 07.
Artículo en Inglés, Noruego | MEDLINE | ID: mdl-37938014

RESUMEN

Balanoposthitis is an inflammation of the glans penis and/or prepuce. It is a common condition with diverse aetiology. A targeted medical history and clinical examination are needed for correct diagnosis and treatment. This clinical review is a summary of the diagnostic process and treatment of balanoposthitis. The work is based on a selection of clinical guidelines and literature, as well as clinical experience from a dermatovenereology outpatient clinic.


Asunto(s)
Balanitis , Masculino , Humanos , Balanitis/diagnóstico , Balanitis/etiología , Balanitis/terapia , Pene , Inflamación , Instituciones de Atención Ambulatoria , Examen Físico
10.
Rev Med Liege ; 78(7-8): 448-450, 2023 Jul.
Artículo en Francés | MEDLINE | ID: mdl-37560959

RESUMEN

Zoon's balanitis is a rare genital dermatosis of unknown etiology, usually presenting as a red-orange macule or plaque with a «cayenne pepper¼ appearance on the glans and/or foreskin. Unfortunately, atypical presentations are not uncommon, including vegetating or ulcerative lesions. Usually, it affects middle-age to older uncircumcised men. Although it is a benign pathology, Zoon's balanitis may be superimposed on another inflammatory or neoplastic dermatosis. As topical treatments are generally non satisfactory and relapses are usual on treatment with-drawal, circumcision remains an interesting option with usually a rapid and complete remission of the symptoms.


La balanite de Zoon est une dermatose génitale peu fréquente d'étiologie inconnue, se présentant habituellement par une macule ou une plaque de couleur rouge- orange avec un aspect en «poivre de cayenne¼, sur le gland et/ou le prépuce. Néanmoins, des formes atypiques, végétantes ou ulcérées, sont possibles. Elle touche plus souvent l'homme d'âge moyen à avancé et non circoncis. Il s'agit d'une pathologie bénigne, mais qui peut se surajouter à d'autres dermatoses inflammatoires ou néoplasiques. Les traitements topiques ne sont pas très efficaces et entraînent généralement une récidive à l'arrêt, tandis que la circoncision permet souvent une disparition rapide et complète des symptômes.


Asunto(s)
Balanitis , Circuncisión Masculina , Enfermedades de la Piel , Masculino , Persona de Mediana Edad , Humanos , Balanitis/diagnóstico , Balanitis/terapia , Balanitis/patología
11.
Urology ; 179: 136-142, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37328011

RESUMEN

OBJECTIVE: To compare proportions of newborn circumcisions, operative circumcisions, chordee procedures, and cases of balanitis in states where Medicaid covers newborn circumcision (covered states) versus states that do not (noncovered states) using the pediatric health information system database. METHODS: A retrospective review of pediatric health information system data was conducted from 2011 to 2020. The proportions and median ages of newborn circumcision current procedural terminology (CPT 54,150, 54,160), operative circumcision (CPT 54,161), chordee (CPT 54,360), and balanitis (ICD-9 607.1, ICD-10 N48.1, N47.6) were compared in covered versus noncovered states. RESULTS: A total of 118,530 circumcisions were reviewed. Covered states had significantly higher proportions of circumcision overall (9.7% vs 7.1%, P < 0.0001). Noncovered states had significantly higher proportions of Medicaid-covered operative circumcisions (54.9% vs 47.7%, P < 0.0001). Compared to covered states, noncovered states had significantly higher median ages of all types of circumcisions. Noncovered states also had higher numbers of balanitis cases and double the incidence of balanitis compared with covered states. The median age of chordee (1.07 vs 0.79 years, P < 0.0001) and proportion of chordee repairs (15.2% vs 12.9%, P < 0.0001) were also significantly higher in noncovered states. CONCLUSION: The lack of Medicaid coverage of circumcision increases the number of foreskin procedures done in the operating room. In addition, in states without Medicaid coverage of circumcision, there is an increased burden of disease related to the foreskin. These findings represent a need to further investigate the costs of healthcare associated with Medicaid coverage of circumcision or the lack thereof.


Asunto(s)
Balanitis , Circuncisión Masculina , Masculino , Recién Nacido , Estados Unidos , Humanos , Niño , Lactante , Medicaid , Circuncisión Masculina/métodos , Prepucio , Costos y Análisis de Costo , Estudios Retrospectivos
12.
Int J STD AIDS ; 34(7): 498-500, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36929714

RESUMEN

We report a case of syphilitic balanitis of Follmann arising in a man with a history of prior infection with syphilis. Few cases have been described in the literature. In our case, a man with history of multiple unprotected sexual contacts presented with erosive balanitis and painless inguinal bilateral lymphadenopathy. All tests for sexually transmitted infections (STIs) performed were negative with the exception of serology for syphilis. We made the diagnosis of syphilitic balanitis of Follmann that was confirmed by prompt resolution after treatment.


Asunto(s)
Balanitis , Linfadenopatía , Sífilis , Masculino , Humanos , Sífilis/complicaciones , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Balanitis/diagnóstico , Pacientes , Treponema pallidum
13.
J Eur Acad Dermatol Venereol ; 37(6): 1104-1117, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36942977

RESUMEN

BACKGROUND: This guideline is an update to the 2014 edition of the European guideline for the management of balanoposthitis. Balanoposthitis describes inflammation of the glans penis and prepuce and is caused by a range of disparate conditions including infection, dermatoses and premalignancy. OBJECTIVE: The main objectives of this guideline are to aid recognition of the symptoms and signs and complications of penile skin conditions and to offer recommendations on the diagnostic tests and treatment for a selected group of these conditions. METHODS: The previous guideline was updated following a literature review and priority was given to randomized controlled trial and systematic review evidence. RESULTS: The updated guideline includes amended management for infective balanitis to provide clear guidance for Group A streptococcal infections, management of on going Lichen sclerosus (to include circumcision and supportive management to reduce the recurrence of genital herpes and warts), additional regimens for Zoonoid change, use of calcineurin inhibitors in management and risk of premalignancy and change of nomenclaturefrom Premalignant conditions to Penile Intraepithelial neoplasia (PeIN). CONCLUSION: Balanoposthitis has a widerange of causes high quality evidence specific to the management of penile disease is not available for all the conditions described.


Asunto(s)
Balanitis , Circuncisión Masculina , Enfermedades del Pene , Neoplasias del Pene , Lesiones Precancerosas , Humanos , Masculino , Balanitis/diagnóstico , Balanitis/terapia , Circuncisión Masculina/efectos adversos , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/tratamiento farmacológico , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/terapia , Neoplasias del Pene/complicaciones , Pene/patología , Lesiones Precancerosas/complicaciones
14.
Sci Rep ; 13(1): 2313, 2023 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-36759665

RESUMEN

We aimed to investigate patient satisfaction with male circumcision in Taiwan. An online, questionnaire-based, cross-sectional study involving 376 circumcised men 20 to 40 years of age in Taiwan was conducted. Circumcision-related satisfaction was defined as a visual analogue scale score ≥ 6 (range, 1-10). Pearson's chi-square test was performed to compare differences between satisfied and unsatisfied participants. Factors predictive of participant satisfaction were analysed using multivariate logistic regression. Statistical significance was set at P < 0.05. Among 376 circumcised men, 249 (66.2%) reported satisfaction with circumcision. Satisfied participants had higher levels of education, underwent circumcision for phimosis or balanitis, underwent circumcision during adulthood, reported a larger penile size, and had fewer long-term complaints. Furthermore, 89.4% had various long-term complaints, including skin colour mismatch, changes in masturbation methods, hypertrophic scarring, excessive shortening of the prepuce, and redundant prepuce. Multivariate analysis revealed that adult circumcision and the absence of long-term conditions were predictive of satisfaction. Two-thirds of participants were satisfied with their circumcision outcome, especially those who underwent circumcision for phimosis or balanitis during adulthood. Proper preoperative patient selection and postoperative symptom prevention would improve patient satisfaction.


Asunto(s)
Balanitis , Circuncisión Masculina , Fimosis , Adulto , Humanos , Masculino , Taiwán , Estudios Transversales , Balanitis/cirugía , Satisfacción Personal
16.
PLoS One ; 17(10): e0275207, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36251658

RESUMEN

PURPOSE: Although circumcision is the most commonly performed surgery in males, less is known about the incidence and indications of adult circumcision. In this study, we aim to present the incidence of adult circumcision across the United States. METHODS: Using IBM MarketScan® Commercial Database from 2015 to 2018, we obtained claims for circumcision in men between 18 and 64 years of age. We calculated the incidence of adult circumcision over the study period and across the United States. We also collected data on indications for surgery using International Classification of Diseases codes. RESULTS: We identified a total of 12,298 claims for adult circumcisions. The mean age was 39 (±12.9) years. The average incidence rates remained relatively constant from 98.1 per 100,000 person-years in 2015 to 98.2 per 100,000 person-years in 2018 (Δ+0.1%). The age-standardized incidence rates varied significantly across the United States (from 0 to 194.8 per 100,000 person-years) with South Dakota having the highest rate. The most common indications for adult circumcision were phimosis (52.5%), routine/ritual circumcision (28.7%), phimosis + balanitis/balanoposthitis (6.8%), balanitis (3.8%) and balanoposthitis (2.6%), and significantly varied by age groups. CONCLUSION: This study suggested a wide geographic variation in rates of adult circumcision between states with highest incidences in the Northeast United States. Future studies can identify the underlying causes for the observed variations.


Asunto(s)
Balanitis , Circuncisión Masculina , Fimosis , Adulto , Balanitis/cirugía , Conducta Ceremonial , Humanos , Incidencia , Masculino , Fimosis/cirugía , Estados Unidos/epidemiología
19.
Pediatr Dermatol ; 39(5): 830-831, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35668547

RESUMEN

Candidal balanitis typically affects sexually active adult males and may present as eroded papules, pustules, whitish discharge or erythema with dry glazed appearance. We report an unusual presentation of this common infection in an uncommon demographic, candidal balanitis presenting as coalescent vesicles and erosions arranged in an arcuate pattern in a pre-school child.


Asunto(s)
Balanitis , Candidiasis Cutánea , Candidiasis , Adulto , Balanitis/diagnóstico , Balanitis/tratamiento farmacológico , Preescolar , Humanos , Masculino
20.
J Eur Acad Dermatol Venereol ; 36(10): 1851-1856, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35695159

RESUMEN

BACKGROUND: Pseudoepitheliomatous keratotic and micaceous balanitis (PEKMB) is a clinicopathological entity characterized clinically by micaceous scale on the glans, and histologically by acanthosis, hyperkeratosis and pseudoepitheliomatous hyperplasia. We present a series of eight cases of this rare condition, the first series of more than two cases to be reported. OBJECTIVES: To determine the clinical and histological characteristics of cases of PEKMB, and evaluate treatments used and clinical course. METHODS: This monocentric case series was conducted at the University College London Hospitals tertiary male genital dermatology clinic between April 2018 and August 2020. Eight patients with PEKMB were evaluated. Data were collected on demographics, clinical presentation, histological features, presence of human papilloma virus (HPV), history of lichen sclerosus, treatment of PEKMB and subsequent response, and presence or development of squamous cell carcinoma (SCC) or penile intraepithelial neoplasia (PeIN) during follow-up. RESULTS: Eight Caucasian males presented with clinical and histological evidence of PEKMB. Seven had a background of lichen sclerosus; two had failed treatment with superpotent topical steroids and four had symptoms for three or more years prior to circumcision. There was no clinical or histological relationship with HPV infection, and p16 staining was negative. HPV PCR, performed in two cases, was negative. Basal atypia, insufficient to amount to PeIN, was present in six patients. One patient progressed to PeIN during follow-up, and no patient progressed to invasive malignancy. Five patients were treated successfully with glans resurfacing and split skin graft reconstruction. CONCLUSIONS: Our observations demonstrate that PEKMB represents a form of chronic, undiagnosed or misdiagnosed, inadequately treated or treatment refractory, unstable lichen sclerosus. The significant potential for squamous carcinogenesis (differentiated PeIN and verrucous carcinoma) can be mitigated by timely diagnosis and treatment. Glans resurfacing and split skin graft reconstruction appears to be a successful treatment modality in patients with refractory disease.


Asunto(s)
Balanitis , Carcinoma in Situ , Queratosis , Liquen Escleroso y Atrófico , Infecciones por Papillomavirus , Neoplasias del Pene , Neoplasias Cutáneas , Balanitis/diagnóstico , Carcinoma in Situ/patología , Humanos , Queratosis/patología , Liquen Escleroso y Atrófico/complicaciones , Liquen Escleroso y Atrófico/patología , Masculino , Papillomaviridae , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/patología , Neoplasias del Pene/cirugía
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