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Zoon's balanitis also known as Balanitis Circumscripta Plasmacellularis or plasma cell balanitis (PCB) is an idiopathic, rare, benign penile dermatosis [7] for which circumcision is often the preferred treatment. The patient was afebrile. The pathogenicity of Malassezia in seborrhoeic dermatitis is probably related to the immune response to the yeast rather than to the amount of yeasts on lesional skin (20). That is why thrush is less common among circumcised men. Severe oedema due to right heart failure. The recommendations on management are largely based on expert opinion in the 2020 European guideline for the management of balanoposthitis [ Edwards, 2020 ], expert opinion in the Royal College of General Practitioners and British Association of Sexual Health and HIV (RCGP/BASHH) publication Sexually transmitted infections in primary care [ Lazaro, 2020 ], expert opinion in review articles on male genital skin conditions [ English et al, 1997 ; Shim, 2020 ] and on penile inflammatory skin disorders [ Morris, 2020 ]. Malassezia was detected in 23 patients (23%) in the balanoposthitis group.

This vulnerability to microbe colonization is further supported by Jackson et al. Home remedies There are no real home remedies for balanitis, other than good hygiene: To participate, an individual must declare whether they have any competing interests or not. We report here the prevalence of these microbes in 100 patients with balanoposthitis and in 26 control patients. Balanitis xerotica obliterans (BXO) is a separate and distinct condition. There was a statistically significant difference between groups (p < 0. )Balanoposthitis is believed to have contributed to the decline to near-extinction of Gilbert's potoroo. If the foreskin is also inflamed, the correct term is balanoposthitis, although balanitis is commonly used to refer to both.

Balanitis is inflammation of the glans penis [1] and is a common condition affecting an estimated 3-11% of males. The sample is used to look for certain germs (bacteria) that can cause infection. Though this surgical procedure is typically done on infants, it can be done safely on a man of any age. 10 Balanitis has a wide variety of causes, including physical trauma, an irritant, or an infection.

  • Men with diabetes may experience more severe symptoms, including fluid buildup and ulceration of the penis, as well as fissuring of the foreskin.
  • Untreated balanitis can cause chronic (long-term) inflammation (redness and irritation).
  • To determine which factors are contributing to balanitis, a swab may be taken for bacterial and yeast culture.

QOF indicators

Sometimes there is a thick clumpy discharge which comes from under the foreskin. Fungal culture and polymerase chain reaction (PCR) study were revealed as Candida albicans. All three conditions affect the penis. If you suffer from pain and irritation of the head of the penis with a discharge, particularly if you have recently engaged in risky sexual activity, you should see your doctor as soon as possible. Most are caused by a bacterial infection in the area which has irritated the lining. Cleaning a child's penis Don't pull back their foreskin to clean under it if it's still fixed.

Fixed drug eruption (particularly with sulfonamides and tetracycline). What are the signs and symptoms of a yeast infection in men? Trichosporon species are known to cause white piedra; white to light-brown nodules loosely attached to the hairshaft, and are most prevalent in temperate and semitropical climates (24). If the foreskin is involved as well, it is referred to as balanoposthitis. Streptococcus pyogenes (SP) is responsible for pharyngitis and impetigo. 3 Kumar reported successful treatment by circumcision. When boys reach the age of 5 years, the foreskin becomes easy to retract, and the risk of balanitis falls.

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Most mild yeast infections will not require treatment and it is not considered necessary unless the man develops symptoms. Balanitis may be associated with systemic symptoms such as painful joints, dermatologic involvement beyond the penis, mouth sores, swollen or painful glands, and malaise or fatigue. When these are negative, the origin of the balanitis is considered 'nonspecific'.

In middle-aged or older men it is called Zoon's balanitis. For the differentiation of M. Other complications of balanitis may include meatal stenosis and possible urethral strictures; urinary retention; and vesicoureteral reflux. Many of the antifungal creams or oral medications recommended for a yeast infection include: And a moist environment is ideal for candida to spread.

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Success is seen particularly in male children older than 10 years compared with those aged 3-10 years. The role of microorganisms in atopic dermatitis. Poorly controlled blood glucose is associated with increased occurrence of candidal species beneath the prepuce, which can lead to balanitis. 76 (normal < 6. Candida: eliminating yeast/fungal overgrowth, but above all, dietitians generally stress eating a wide range of nutritious foods – fruits and vegetables and healthy sources of fiber, where most Americans fall short – is key to proper gut health and better overall health. )

HPV Some studies have raised a question regarding a possible link between the human papillomavirus (HPV) and chronic balanitis and balanoposthitis, though HPV has not conclusively been shown as a cause and more study is necessary. Balanitis can happen at any age. You can help prevent a penile yeast infection by avoiding sexual contact with a partner who has a yeast infection. The foreskin (the loose flap of skin that covers the head of the penis) is also often affected. The pruritus subsided and the eruptions were greatly diminished. Thrush is a yeast infection caused by a fungus called Candida Albicans. 15 Zoon's balanitis must be distinguished from the similar appearing Erythroplasia of Queyrat, which is a cancerous condition. Poor hygiene may lead to an accumulation of smegma (a buildup of dead cells and body oils on the genitals) that reduces aeration and irritates the skin of the penile head, ultimately causing inflammation and swelling.

Balanitis caused by a bacterial infection may be treated with antibiotic medications.

Treating the underlying cause often clears up symptoms. Some people find that salt baths are soothing whilst treatment takes effect. More recently, Albertini et al. Comments are accepted in any format that is convenient to the reviewer, although an electronic format is encouraged. Balanitis xerotica obliterans (BXO) is lichen sclerosus of the glans penis (uncommon). Good hygiene and safe sex lower the risk significantly. A diagnosis of balanitis secondary to a mixed infection with SP and CA was made.


Infections, whether viral, bacterial or fungal, can cause balanitis to develop. Men should never use perfumed shower gels or soaps on their genitals. Inflammation has many possible causes, including irritation by environmental substances, physical trauma, and infection such as bacterial, viral, or fungal.

It is possible that the inflammatory lesions on the prepuce and glans penis of the patients who presented with Malassezia and reported seborrhoeic dermatitis were a genital manifestation of seborrhoeic dermatitis itself.


Apply bacitracin (not Neosporin) for pediatric patients if bacterial infection is suspected. Uptodate, mycelex-7 cream:. No – unless an infection has been detected. 2020 ICD-10-CM Diagnosis Code B37. For example, if you take dapagliflozin (Farxiga), you’re more likely to get balanitis, because the drug works by flushing sugar out of your body in the urine. In refractory cases, circumcision may be necessary to prevent recurrence.

Teach proper hygiene: You’re not likely to have any serious side effects. In this article we focus on a yeast infection in men – a penile yeast infection. Viral - eg, herpes simplex, human papillomavirus. Pseudoepitheliomatous keratotic and micaceous balanitis:

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There are several risk factors that increase a man's risk of getting a penile yeast infection, including: Circumcision may be advised in rare cases where a child keeps getting balanitis. Most cases of balanitis are easily managed with a combination of creams or ointments, good hygiene and avoiding substances that irritate the penis. Zoon’s balanitis: It is a good idea to wash the penis regularly with plain warm water, avoiding shower gels and soaps, and drying well after. One etiological category is infectious agents which include candida, anaerobic or aerobic bacterial infections, human papillomavirus, herpes simplex, gardnerella vaginalis, treponema pallidum which causes syphilis and borrelia burgdorferi which causes Lyme disease. Identification of Malassezia species.

Only cultures with growth that was moderate to heavy were included in our analysis of data. This suggests an increased sensitivity to irritants in the genital skin and mucous membranes of these patients. Superficial fungal infections.

6 If the inflammation is caused by NSD, the treatment is to stop washing with soap, apply emollients, and allow natural skin oils to return. Staphylococci/streptococci (especially Group B). Presence of foreskin Morbid obesity Poor hygiene Diabetes; probably most common Nursing home environment Condom catheters Chemical irritants Edematous conditions: Very occasionally, an early type of skin cancer can present as inflammation of the end of the penis. In total, moderate to heavy growth of C.

  • Frequency and global burden Common.
  • Also visit your doctor if your son develops balanitis.
  • (05) (Table II).
  • Recent developments in the immunology and biology of Malassezia species.
  • The information on the differential diagnosis of balanitis is based on expert opinion in the 2020 European guideline for the management of balanoposthitis [ Edwards, 2020 ] and expert opinion in the Royal College of General Practitioners and British Association for Sexual Health and HIV (RCGP/BASHH) publication Sexually Transmitted Infections in Primary Care [ Lazaro, 2020 ].


A mild steroid cream to reduce inflammation is useful for balanitis caused by allergies or irritants. If the topical or oral treatments don't work, make sure to see your doctor, as you may have another kind of balanitis or an infection by a Candida species resistant to azole antifungals. If no cause can be found, saline washes several times a day can help symptoms and relieve the inflammation. The main complication of balanitis is phimosis. Yeast infections, or candidiasis, can affect other areas of the body:

However, each condition affects a different part of the penis. Common fungal infections of the foot are foot fungus, toenail fungus, toe infection. What are the symptoms of balanitis? Bergbrant IM, Faergemann J. 4 Small erythematous papules and pustules coalesce to form serpiginous erosive or crusted plaques on the glans penis. Causes include skin disorders, infection, poor hygiene, uncontrolled diabetes and overuse of soaps.

(7%) Malassezia spp 23 (23%) 6 (23%) *p < 0. The sample can be taken to be looked at under the microscope. Suggested ways for Malassezia to induce symptoms are through precipitating antibodies against the yeast, production of toxin, lipase activity and activation of complement (21, 22). For more information on BXO, visit Balanitis Xerotica Obliterans. If conservative treatments aren't effective in uncircumcised boys and men, circumcision will usually correct the problem. The combination of C. Do not use soap. In one of the 3 patients with β-haemolytic group C streptococci there was a simultaneous finding of C.

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Pustules were noted in only 5 of our patients, 2 of whom presented with C. They may need prescription-only medication, such as antibiotics. One patient in the balanoposthitis group reported psoriasis but had no clinical signs thereof. It is proposed that this reflects an increased susceptibility to irritants causing dermatitis and subsequent colonization or infection with microbes in the area of the prepuce and glans penis of these patients. Symptoms of Balanitis: For severe symptoms patients can use oral fluconazole or 1% hydrocortisone cream as an adjunct to topical imidazole.

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But if it's caused by an infection, like an STI or thrush, there's a risk of passing this on. Malassezia was found in 49% of these men and the authors suggested a role in pathological processes of the penis, such as balanoposthitis, seborrhoeic dermatitis and psoriasis. On clinical suspicion of Zoon balanitis a punch biopsy was taken from the glans penis of a 64-year-old man and this confirmed the diagnosis. Phimosis is a condition that makes it difficult to retract the foreskin. Inflammation is visible.

If soap is used for washing, all residual soap should be rinsed away. If untreated, balanitis can cause swollen and painful glands, as well as weakness and fatigue. Presentation is with irritation or pain in the penis and discharge from beneath the foreskin. This inflammation and edema may lead to adhesions with adherence of the prepuce to the glans and scarring of the foreskin. In sexually mature males, accumulated smegma should be washed away periodically.

When lesions occur around the nails, it is common for there to be hyperkeratosis underneath the nails. It may be impossible to pull the foreskin back. The oral mucosa is a difficult site to deliver medication topically, and the genital area may develop irritant reactions to certain topical medications.


The diagnosis of balanoposthitis was based on the presence of one or more of the following criteria; erythema, papules, pustules, transudate, white membranes or fissures in the area of the prepuce and glans penis. If you are uncircumcised, clean under the foreskin with soap and water, and return your foreskin to its usual position after you have sexual intercourse. Circumcision is usually recommended in patients with persistent tightness of the foreskin, once the inflammation has resolved. The causes of balanoposthitis are diverse and include inflammatory dermatological disorders, such as Zoon balanitis, lichen planus, seborrhoeic dermatitis and psoriasis, premalignant conditions including Bowen’s disease and penile intraepithelial neoplasia, various infections and contact allergies (2).

Penile Lichen Sclerosus (et Atrophicus)

All positive Candida cultures, including those with very discrete or discrete growth, are presented in Table III. The antibiotic will depend on the type of infection. Success ranges from 65-95%. If the balanitis is caused by an infectious organism, the organism should be identified and the appropriate medical treatment determined based on the identifed infectious agent. To determine the cause of symptoms men should always be tested. Treating balanitis Most cases of balanitis are easily treated with good hygiene and creams and ointments recommended by your GP.


One somewhat distinguishing histologic feature is that the older lesions of keratoderma blenorrhagica may have a considerably thickened stratum corneum, corresponding to the markedly hyperkeratotic papules seen grossly. In fact, skin candida albicans or mushrooms prefer growth environments that are similar to those ideal to grow edible mushrooms, that is; warmth, humidity and darkness. Sometimes yeast infections return after they appear to be cured. So, in certain cases your doctor is able to diagnose the cause and advise on treatment straightaway. Balanitis is the medical term used for inflammation of the glans penis (head of the penis). While balanitis is not usually serious, it can be a sign of another condition, such as a sexually transmitted infection (STI) or thrush (a type of yeast infection). You are more likely to develop a balanitis if you have a phimosis, as sweat, debris and urine may collect under the foreskin.

Gupta AK, Kohli Y, Summerbell R C, Faergeman J. Simultaneous presence of bacteria and yeasts in the balanoposthitis and control groups C. Proctitis is the inflammation of the top 6 inches of rectal lining called the rectal mucosa which is situated in the rectum. If you don’t keep that area clean, you raise your chances of getting the infection. Also called lichen sclerosus, BXO occurs when skin on the glans hardens and turns white.

Your doctor might begin by asking you about your symptoms and examining your penis. Plugged ducts, mastitis, and thrush, • While nursing on a candida-infected nipple can be exquisitely painful, it is necessary to keep the affected breast empty to prevent mastitis, or even a candida infection deeper into the breast tissue. If symptoms are not improving by seven days: Don't use soap, bubble bath, shampoo or any other potential irritant. Candidal balanitis resolves rapidly with appropriate treatment but is more likely to recur in men with: More serious, or longer-term infections may require a prescription-strength medication. We suggest that the primary therapeutic target in mild to moderate cases of balanoposthitis should be to decrease inflammation with a mild corticosteroid cream.

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However, treatment depends on cause, so smears can be taken from the discharge to identify common sexually transmitted diseases. A number of conditions can cause the glans to become inflamed, including infections; certain diseases; injuries; and allergic reactions to medications, latex condoms, or harsh soaps. However, once symptoms do appear, they can cause extreme discomfort and pain. Candidiasis is one of the most common causes of balanoposthitis. The urine should be tested for glucose in all cases and particularly in the case of candida balanitis in middle-aged men. Boys under the age of 4 years and uncircumcised men are at the highest risk, but it can happen at any age. Thrush is curable.

Balanitis is a skin irritation on the head of the penis that can affect men and boys. Men get yeast infections, too! Symptoms of a vaginal yeast infection are more likely to occur during the week before a menstrual period. Swab of discharge for microscopy, Gram staining, culture and sensitivity. An inflammation of the glans penis Posthitis is an inflammation of the foreskin. To date, there have been no reports of K. In the balanoposthitis group 19 patients (19%) exhibited S. Balantitis is treatable and curable.