Balanoposthitis. / Balanopostitt.

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.

Genital diseases in the mature man.

Elderly men are at higher risk of developing genital dermatologic problems, including inflammatory and neoplastic conditions due to age-related physiologic changes, immunosenescence, comorbidities, and iatrogenesis. Clinical manifestations of genital dermatoses in men are varied and may include itching, pain, redness, dermatitis, lumps, and ulcers. Even when asymptomatic, the psychologic impact may be significant. Sexual or urinary dysfunction may complicate genital dermatoses. Early and accurate diagnosis is essential to reduce morbidity and mortality from premalignant and malignant conditions and also to prevent sexual dysfunction and unnecessary anxiety in the case of benign entities.

[Dermato-urology: Male genital lesions urologist should know]. / Dermato-urologie : les lésions des organes génitaux externes de l'homme à connaître par l'urologue.

This article aimed to gather male genital dermatoses that may lead to consult a urologist, except pre-neoplastic or neoplastic lesion. METHOD: This review is based on a research on Pubmed and EM-consult database, in English and in French, using the following key terms "male genital dermatoses", "male genital lesions", "balanitis", "balanoposthitis", "dermatoses des organes génitaux externes masculines", "lésions des organes génitaux externes de l'homme", "balanoposthites". RESULTS: It highlights normal morphological aspects, acute balanoposthitis (nonspecific, infectious, allergic, irritative and traumatic), common skin disease localized to male genital and male genital specific dermatoses. CONCLUSION: Any suspicious, fixed, must lead to a skin biopsy.

Zoon Balanitis Revisited: Report of Balanitis Circumscripta Plasmacellularis Resolving With Topical Mupirocin Ointment Monotherapy.

INTRODUCTION: Zoon balanitis is an idiopathic benign inflammatory condition of the glans penis and prepuce. A patient with biopsy confirmed diagnosis of Zoon balanitis who was successfully treated with topical mupirocin ointment monotherapy is described.

METHOD: A search using PubMed database was performed using the following terms: Zoon balanitis (cases, diagnosis, treatment of), balanitis circumscripta plasmacellularis, and mupirocin. Relevant papers and their reference citations were reviewed and evaluated.

RESULTS: The gold standard of treatment for Zoon balanitis has previously been circumcision. More recently, topical calcineurin inhibitors have been shown to be effective. Our patient had successful resolution of his Zoon balanitis after 3 months of mupirocin ointment monotherapy.

DISCUSSION: Zoon balanitis is a benign inflammatory dermatosis. Previous successful treatment modalities include circumcision, phototherapy, laser therapy, and topical calcineurin inhibitors. Topical mupirocin ointment twice daily resulted in resolution of Zoon balanitis in our patient. Additional evaluation of mupirocin ointment as a therapeutic agent should be considered as a potential first-line therapy in patients with Zoon balanitis.

J Drugs Dermatol. 2017;16(3):285-287.

[Traversing the vertical pedicle flap for the treatment of severely buried penis in children].

OBJECTIVE: To assess the effect of traversing the vertical pedicle flap (TVPF) for the treatment of severely buried penis in children. METHODS: Totally 43 children with severely buried penis underwentTVPF (n = 21)or modifiedShiraki surgery (control, n = 22) in our hospitalfrom February to December 2014. Wecompared the operation time, intra-operation blood loss, foreskin swelling time, and parents' satisfaction with penile appearance between the two groups. RESULTS: No statistically significant differences were observed between the TVPFand control groups in the operation time (ï¼»45.0 ±6.8ï¼½ vs ï¼»42.0 ±5.3ï¼½ min, P>0.05) or intra-operation blood loss(ï¼»5.0 ±1.2ï¼½ vs ï¼»6.0 ±0.8ï¼½ ml, P>0.05). The average foreskin swelling time was markedly shorter in the TVPFgroup than in the control (ï¼»9.0 ±2.3ï¼½ vs ï¼»15.0 ±4.8ï¼½ d, P<0.05)and the parents' satisfaction with penile appearancewas higher in the former than in the latter (95.23vs31.81 %, P<0.05). The elastic bandages were removedfor all the patientsat 3 days postoperatively, and 3 to 6-month follow-up revealed no penile retraction or relapse. CONCLUSIONS: The method of traversing the vertical pedicle flap is a feasible surgical option for the treatment of severely buried penis in children, which can make a rational use of the foreskin,remove the tight ring, and achieve a satisfactory appearance of the penis.

Balanitis: A Unique Presentation of Diabetes in an Elderly Male.

While diabetes is a common medical condition, the initial presentation of patients with diabetes may vary. In some cases, different types of infections or inflammatory conditions may prompt a patient to seek medical attention. Males may present to their primary care provider with a bothersome inflammation of the penis that may be the first recognition of previously undiagnosed diabetes. Balanitis is an inflammation of the glans of the penis that may prompt a patient to seek medical care. While there are several different causes of balanitis, underlying medical conditions such as uncontrolled diabetes have been associated with balanitis. The genital irritation prompts patients to seek medical evaluation, and at that point diabetes is diagnosed. It is important for pharmacists to recognize that balanitis is a potential though uncommon type of diabetes presentation. It is also important for pharmacists to review other aspects of diabetes care once a patient is diagnosed with diabetes.

Balanopostitis de causa inusual. Una nueva etiología: «Stenotrophomonas maltophilia» / Balanoposthitis of unusual cause. A new etiology: Stenotrophomonas maltophilia

La balanitis, o inflamación del glande, y la postitis o inflamación local del prepucio, son muy frecuentes en niños habitualmente no circuncidados. Suele ser de origen infeccioso, causada por estreptococos, anaerobios u hongos. La infección por Stenotrophomonas maltophilia, patógeno nosocomial emergente, es poco frecuente en la infancia. Es un microorganismo poco virulento que puede originar brotes epidémicos. Se desarrolla en casi cualquier entorno acuático o húmedo, incluido el suministro de agua potable. La S. maltophilia es un patógeno humano emergente que se detecta cada vez en más situaciones y supone un nuevo reto para los pediatras y microbiólogos. Presentamos el caso clínico de un varón con balanopostitis aguda por S. maltophilia (AU)

Balanitis describes inflammation of the glans penis; posthitis is inflammation of the prepuce. Balanoposthitis can be caused by a disparate range of infective agents affecting the penile skin. Stenotrophomonas maltophilia is an ubiquitous environmental bacterium and an opportunistic pathogen, which has recently been recognized as an emergent nosocomial agent. S. maltophilia is a new challenge for microbiologist and pediatricians. We present a S. maltophilia acute balanoposthitis case in a boy (AU)

Genome-wide association study for posthitis in the free-living population of European bison (Bison bonasus).

BACKGROUND: About 5-6% of the European bison (Bison bonasus) males are affected by posthitis (necrotic inflammation of the prepuce) and die in the wild forest. Despite many years of study, pathogenesis of this disease has not yet been determined. The main aim of the study was to find SNP markers significantly associated with the incidence of posthitis and mine the genome for candidate genes potentially involved in the development of the disease. RESULTS: It was shown that relatively small number of SNPs effects reached genome-wide significance after false discovery rate (FDR) correction. Among 25 significant markers, the highest effects were found for two SNPs (rs110456748 and rs136792896) located at the distance of 23846 bp and 37742 bp, respectively, from OR10A3 gene (olfactory receptor genes), known to be involved in atopic dermatitis in humans. It was also observed that five other significant SNP markers were located in the proximity of candidate genes involved in severe diseases of skin tissue and cancer/tumour development of epithelial or testicular germ cells, which suggest their potential participation in the posthitis. The 25 investigated SNPs showed marked differences in allelic and genotypic frequencies between the healthy and affected bison groups. CONCLUSIONS: The 2 Mb region of the BTA15 chromosome is involved in genetic background of posthitis and should be closer examined to find causal mutations helpful in better understanding of the disease ethology and to control its incidence in the future.

Non-infectious inflammatory genital lesions.

The genitalia may be the site of non-infectious inflammatory lesions that are generally manifested as balanoposthitis and vulvovaginitis. In men, these forms constitute 50% of all balanoposthitis forms, and in women, vulvovaginitis frequency is even higher. They consist of genital locations of general skin diseases, such as psoriasis, lichen planus, lichen sclerosus, and other clinical entities with their own physiognomy, such as Zoon's balanitis-vulvitis. Diagnosis of genital non-infectious inflammatory lesions is usually made on clinical criteria. A biopsy is only necessary for the identification of clinical conditions that may simulate inflammatory form but are actually premalignant processes.

Genital mycotic infections in patients with diabetes.

Patients with diabetes, especially those with poorly controlled glycemia, are prone to developing genital mycotic infections-vulvovaginal candidiasis in women and Candida balanitis in men-the latter almost exclusively in uncircumcised men. Candida albicans is the most common pathogen causing balanitis and is also the dominant cause of vulvovaginal candidiasis in women with diabetes, although Candida glabrata is a prominent pathogen in women with type 2 diabetes mellitus. Candida glabrata is less virulent but also less susceptible to conventional antifungal treatment. High blood glucose levels promote yeast attachment and growth, and also interfere with immune responses in the host. In uncircumcised men, the moist, warm space underneath the foreskin is thought to promote yeast growth, especially when hygiene is poor. Several other risk factors have been identified that predispose to genital mycotic infections, including antibiotic use, corticosteroid use, immunosuppression, atopy, and, in women only, genetics, pregnancy, estrogen/oral contraceptive use, and select sexual behaviors (eg, orogenital sex). In patients with hyperglycemia, risk is increased for not only incident infection but also for recurrence, underscoring the key role of establishing and maintaining euglycemia in the management of genital mycotic infections in patients with diabetes. In addition to blood glucose control, first-line treatment involves either an antifungal cream/ointment (or suppository for women only) that is applied intravaginally by women and directly to the affected area(s) by men, or oral treatment, which infrequently causes systemic side effects. Antifungal treatment should also be offered to sexual partners of patients with diabetes with a genital mycotic infection if the partner is similarly infected. Given high efficacy rates, follow-up test-of-cure after the completion of treatment is generally unnecessary.

[Circumcision accidents in Yaoundé, Cameroon: a report on five cases]. / Les accidents de la circoncision à Yaoundé, Cameroun: à propos de cinq observations cliniques.

MATERIAL AND METHOD: Within a period of two months, (from July to August 2007), five accidents resulting from circumcisions were recorded in the pediatric surgical unit of Gynaeco-Obstetric and Paediatric Hospital Yaoundé. RESULTS: Average age was 7.75 years within a range of 4-10 years. Anatomic/clinical pathologies recorded were: (a) one case of haemorrhage; one case of balanitis; (b) one case of amputation of the glans penis and (d) two cases of urethral fistula. CONCLUSION: This study brings out the ritualistic nature of circumcision rather than its therapeutic approach. Knowing fully the impact of accidents arising from the act of circumcision, there is no doubt that circumcision is entirely a surgical procedure requiring primarily the services of a paediatric surgeon. Its practice by other health care personnel like wise tradi-practioners should be under strict control.

[Management of balanitis]. / Conduite a tenir devant une Balanite.

Balanitis set in practice an aetiological and therapeutical problem. The clinical aspect is not specific except for the pustules which evoke a candidiasis. The mycological and bacteriological cultures should be performed in accordance with the clinical context. The biopsy is useful in case of chronic balanitis resistant to the treatment. Irritation and candidal infection are the main causes. Herpes and primary syphilis should be systematically ruled out. The treatment should not be aggressive and must take into account the possible psychological impact.