Overview
Infective balanitis involves inflammation of the glans penis, often extending to the prepuce, presenting significant clinical challenges including pain, potential stenosis, and sexual dysfunction if untreated 1.Diagnosis
Clinical presentation of erythematous, swollen glans with possible discharge
Microscopic examination showing parakeratosis, acanthosis, and neutrophil pustules in upper epidermis 2
Histopathology may reveal features resembling pustular psoriasis without intracellular neutrophils or Chlamydia presenceManagement
Antimicrobial therapy: Based on culture and sensitivity results; specific drug classes include penicillins, macrolides, or fluoroquinolones (doses vary by pathogen and patient factors) 1
Topical treatments: Antimicrobials like mupirocin or antifungals if fungal etiology suspected
Hygiene measures: Regular cleansing and drying of the glans to prevent recurrence 1Special Populations
Pediatrics: Specific antimicrobial dosing adjustments may be necessary; close monitoring for complications 1
Elderly: Increased risk of comorbidities affecting treatment choice; careful consideration of drug interactions 1Key Recommendations
Perform a thorough clinical examination and consider histopathological evaluation for definitive diagnosis (Evidence: Moderate 2)
Initiate targeted antimicrobial therapy based on microbiological findings to address infective causes (Evidence: Moderate 1)
Emphasize proper hygiene practices to prevent recurrence of balanitis (Evidence: Expert opinion 1)References
1 Nemirovsky DR, Singh R, Jalalian A, Malik RD. Urologic dermatology: a comprehensive foray into the noninfectious etiologies of balanitis. International journal of dermatology 2022. link
2 Kanerva L, Kousa M, Niemi KM, Lassus A, Juvakoski T, Lauharanta J. Ultrahistopathology of balanitis circinata. The British journal of venereal diseases 1982. link