- Balanitis = inflammation of glans
- Balanoposthitis = inflammation of glans + foreskin (e.g. only in uncircumcised males)
- Balanitis xerotica obliterans = chronic atrophic dermatitis; white atrophic plaques on glans (uncommon in children)
- Zoon's balanitis = non-infectious balanitis
- Consider if no response to treatment > 4 wks
- Flat shiny red/orange lesion; often 'kissing lesion' where prepuce touches it on the glans
- Should biopsy to rule out carcinoma in situ
- History
- Genital itching, discharge, dysuria
- Uncircumcised, unable to retract foreskin, poor hygiene, irritants (eg excessive soap/cleaning), diaper dermatitis
- Rarely - urinary retention or difficulty voiding (due to pain)
- Do not cath them - have to relax them until they pee. Cath just causes more inflammation/pain and perpetuates the cycle
- Typically doesn't occur until potty training (parents cleaning with diaper change -> kid has to clean it themselves)
- Exam
- Reinforce hygiene, avoid forced retraction of the foreskin in young boys, avoid irritants
- Candidal rash - clotrimazole cream
- Physiologic phimosis - no set 'time' for when foreskin should be retractable. Most by age 3, but some not until puberty. Do not forcibly retract foreskin in young boys; have physiologic adhesions that will tear
- Pathologic phimosis - 0.05% betamethasone cream (super high potency), or triamcinolone 0.1% (high potency) BID x six weeks and stretching exercises
- Steroids do not work post-pubertally or for scarred adhesions
- Simulates pubertal testosterone surge which loosens the foreskin
- Circumcision for recurrent balanitis
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last edited: June 21, 2024, 4:27 p.m. | pk: 164
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