Balanitis
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Balanitis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishal Devarkonda, M.B.B.S[2]
Synonyms and keywords: Balanoposthitis
Overview
Balanitis is inflammation of glans penis. When inflammation involves the foreskin and prepuce, it is termed as balanoposthitis. Based on the etiology, balanitis can be mainly categorized into infectious, inflammatory dermatoses, and penile carcinoma in situ. Patients with balanitis may present with asymptomatic or symptomatic lesions with itch or pain in the genital region. Risk factors, pathogenesis, clinical presentation, diagnosis and management varies from etiology to etiology.
Classification
There is no established classification system for Balantis. Based on the etiologies, Balanitis can be classified into:[1]
- Infectious
- Non-infectious balanitis
Causes
Infectious balanitis
Common causes of infectious balanitis
Fungal
- Candida (most common cause)
Protozoal
spirochaetes
Viral
Less common causes of infectious balanitis
Fungal
- Dermatophytosis
- Pityriasis versicolor
- Histoplasma capsulatum
- Blastomyces dermatitidis
- Cryptococcus neoformans
Viral
Protozoal
Parasitic
Bacterial
Gram negative bacteria
- E.coli
- Pseudomonas
- Haemophilus parainfluenzae
- Klebsiella
- Neisseria gonorrhoea
- Haemophilus ducreyi
- Mycoplasma genitalium
- Chlamydia
- Ureaplasma
- Gardnerella vaginalis
- Citrobacter
- Enterobacter
Spirochaetes
- Non-specific spirochaetal infection
Gram positive organism
Acid fast bacilli
Anaerobes
Non-infectious balanitis
Inflammatory dermatoses conditions causing balanitis
- Lichen sclerosus
- Lichen planus
- Zoon's balanitis
- Psoriasis
- Circinate balanitis
- Eczema
- Seborrhoeic dermatitis
- Fixed drug eruption
- Non-specific balanoposthitis
Penile carcinoma in situ causing balanitis
Differential Diagnosis
| Symptoms | Signs | |||||
|---|---|---|---|---|---|---|
| Malaise | Pruritus | Skin lesions | Regional lymphadenopathy | Erythema | Swelling | |
| Candida balanitis | - | + | Erythematous rash with soreness and/or itch | + | + | - |
| Trichomonas vaginalis | - | + | Superficial erosive balanitis | - | + | - |
| Treponema pallidum | - | - | Multiple circinate lesions | + | - | - |
| Herpes simplex | + | + | Grouped vesicles on erythematous base | + | + | - |
| Human papilloma virus | - | + | Warts | - | - | - |
| Lichen sclerosus | - | + | White patches on glans | - | - | - |
| Lichen planus | - | + | Purplish lesions on the penis | - | - | - |
| Psoriasis | - | + | Red scaly plaques | - | + | - |
| Circinate | + | + | Greyish white areas on the glans | - | - | - |
| Zoon's balanitis | - | + | Well-circumscribed orange-red glazed areas | - | - | - |
| Eczema | - | + | Mild non-specific erythema to wide spread edema of penis. | - | + | + |
| Fixed drug eruption | - | + | Well demarcated and erythematous lesions | - | + | - |
| Bowen's disease | - | + | Multiple, small, well-demarcated papillomatous papules | - | - | - |
| Bowenoid papulosis | - | + | Single or multiple, sharply demarcated associated with scaling and crusting | - | - | - |
| Erythroplasia of Queyrat | - | + | Velvety patches and plaques of keratinization on penis. | + | - | - |
References
- ↑ Edwards SK, Bunker CB, Ziller F, van der Meijden WI (2014). "2013 European guideline for the management of balanoposthitis". Int J STD AIDS. 25 (9): 615–26. doi:10.1177/0956462414533099. PMID 24828553.