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.

[Ulcerative Zoon's balanitis]. / Balanite de Zoon ulcérée.

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.

2022 European guideline for the management of balanoposthitis.

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.

Patología peneana y vulvar en la edad pediátrica / Penile and vulvar pathology in the pediatric age

La patología del pene y la vulvar en niñas es un motivo de consulta muy frecuente en urología pediátrica y suele ser origen hasta de consultas por problemas que no lo son, como las adherencias balanoprepuciales, la fimosis -fisiológica en el recién nacido y lactante- o el tamaño, que siempre preocupa por defecto. Describimos los principales procesos que solemos encontrar en consulta tanto de urología pediátrica como en atención primaria

The pathology of the penis as well as the vaginal pathology in girls are a very frequent presentation in pediatric Urology and usually comes from consultations for problems that are not, such as balanopreputial adhesions, phimosis, or the size of the penis that always worries about. We will describe the main processes that we find in consultation urology and primary care

[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.

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)

Diabetes and balanoposthitis.

This review describes the association of balanoposthitis with diabetes. It reviews the multifaceted relationship of both conditions, and summarizes the etiology, clinical features and treatment options for this condition. The commonest etiology of balanoposthitis in males with diabetes is Candida, and the mainstay of treatment is maintenance of hygiene, euglycaemia, and eradication of infection. The review sensitizes diabetes care providers to take a history and perform a physical examination in persons with penile symptoms, and also encourages dermatology care providers to screen for diabetes in such persons.

[MICROBIOLOGICAL ASPECTS OF INFECTIOUS BALANOPOSTHITIS].

Treatment and prevention of diseases of the male reproductive organs largely influence male population fertility and the health of the future generations. This review summarizes current views on the problem of infectious balanoposthitis and presents generalized information on its pathogens. Refined classification and diagnostic workup are provided. The important role of pathogenic microflora in the formation of the glans penis and foreskin inflammation is shown. Importance of Enterococcus spp. in the etiology of balanoposthitis is demonstrated. The modern treatment regimens and prevention of balanoposthitis are described.

The value of a multi-specialty service, including genitourinary medicine, dermatology and urology input, in the management of male genital dermatoses.

We undertook a retrospective case note review of our monthly multi-specialty penile dermatoses clinic (which includes clinicians from Genitourinary medicine, Dermatology and Urology), to examine conditions presenting to the service, and compare clinical management and outcomes with other similar services in the UK. Over the 3-year study period, 226 patients were reviewed over 240 individual episodes. Lichenoid conditions were the most common category of genital pathologies seen (n = 60, 24%), but non-specific balanitis was the most common individual diagnosis (n = 55, 22%). Other common conditions seen included eczema and psoriasis (n = 28, 11%), Zoon/plasma cell balanitis (n = 26, 10%), malignancy/pre-malignant change (n = 25, 10%) and infective conditions (n = 24, 9%). The clinic had a biopsy rate of 10%; the most common indication was for confirmation of a clinical suspicion of malignancy/pre-malignancy. There was a high clinical-to-histological correlation in the biopsies of 79%. The most common treatment prescribed was topical corticosteroids and the clinic had a high discharge rate of 93%, the majority of patients discharged back to General Practice.

[Differential diagnosis and management of balanitis]. / Differenzialdiagnose und Management der Balanitis.

Balanitis is a descriptive diagnosis for a heterogeneous group of infectious or inflammatory dermatoses which have to be differentiated from malignant conditions. Balanitis is caused not only by Candida spp. and bacterial infections, including anaerobic bacteria: viral infections, parasites and other sexually transmitted infections (STI) also have to be considered. Lichen planus, psoriasis and contact dermatitis can characteristically lead to inflammatory conditions of the glans penis. In addition to a complete skin examination, a thorough patient history with respect to topically applied products and sexual behavior is essential. Infections must be treated and the glans penis should be kept dry. It is important to ensure a balanced genital hygiene in patients. As a last resort therapeutic circumcision can be considered for most forms of chronic balanitis.

Balanitis plasmocitaria de loon / Plasma cell Zoon balanitis

La balanitis de células plasmáticas o balanitis de Zoon, es una dermatosis inflamatoria del pene, de tipo plasmocelular circunscrita, curso crónico recurrente y etiología idiopática, más frecuente en varones adultos mayores, que por su presentación se puede confundir con la eritroplasia de Queyrat. Se presenta el caso de un paciente varón de 82 años con tiempo de enfermedad de 8 años que acude a consulta por presentar lesiones eritematosas granulomatosas, ulceradas y sangrantes en área prepucial. Se realiza biopsia donde se observa adelgazamiento de la epidermis, con ausencia de las capas granular y córnea, y presencia de infiltrado en banda de células plasmáticas. Se confirma el diagnóstico de balanitis plasmocitaria de Zoon y se inicia tratamiento con tacrolimús 0,1 %,fluconazol y econazol con buena respuesta al tratamiento.

Zoon 's balanitis or plasma cell balanitis is an inflammatory dermatosis of penis, type circunscripta plasmocellular, recurrent, chronic course and idiopathic etiology, more frequent in older adult males, which can be confused with the erythroplasia of Queyrat for his presentation. The case of a male patient of 82 years with disease 8 years duration that presented erythematous granulomatous lesions, ulcerated and bleeding in the preputial area is presented. Biopsy showing thinning of the epidermis, is performed with the absence of layers granular and cornea, and presence of band of plasma cell infiltrate. The diagnosis of plasmocytaria Zoon balanitis was confirmed and treatment with tacrolimus 0,1 %,fluconazole and econazole was iniciated with good response to treatment.

Black stone - a natural remedy for premature ejaculation and performance enhancement, or maybe not?

We describe the use of a non-prescribed aid (Black stone) for premature ejaculation that resulted in a chemical burn on the penis with an appearance similar to severe balanitis.

Erythematous penile lesion.

Previous efforts to diagnose the cause of this patient's rash had been unsuccessful. A biopsy confirmed our suspicions.