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Author(s): Dr Casey Paul Schukow, Michigan University College Medicine, United States. Copy edited by Gus Mitchell. June 2022
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Balanitis is an inflammatory condition of the glans penis (head of the penis).
Inflammation often involves the foreskin, or prepuce, which is more appropriately known as balanoposthitis. Many urologic clinic visits are due to balanitis, which may be caused by infection, trauma, irritation to the glans penis, and allergic dermatitis. Untreated balanitis can have a wide range of complications, such as urethral stenosis, phimosis, and malignancy.
Balanitis is present in up to 6% of young men and has an approximate overall prevalence of 3-11%.
Other risk factors include:
Balanitis can be best categorised as infectious versus non-infectious aetiologies.
Infectious aetiologies include, but are not limited to:
Non-infectious aetiologies include, but are not limited to:
Clinical features of balanitis vary depending on the specific aetiology.
In general, clinical features include, but are not limited to:
Specific clinical features can be characterised by the following examples.
Erythema and inflammation may appear more violaceous/dark blue as opposed to red in patients of darker Fitzpatrick skin types.
Sexually transmitted infections should be excluded, especially in sexually active persons. HIV should be ruled out in cases not responding to therapy and/or non-typical presentations.
Non-infectious eczematous cause:
For more severe inflammatory causes of balanitis (such as Zoon’s balanitis, genital lichen planus, BXO):
Pre-malignant causes of balanitis (such as erythroplaisa of Queyrat):
Most individuals with balanitis recover without complications with appropriate treatment and genital hygiene measures. In those who are uncircumcised, it is not uncommon for balanitis to recur.
Phimosis and paraphimosis are emergent complications of balanitis and must be evaluated by a urologist.
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