Balanoposthitis refers to inflammation of the glans penis and prepuce. It is a descriptive term and not a diagnosis.
There are numerous causes; these can be broadly divided into inflammatory, infective, and pre-cancerous.
The aim of diagnosis and management should be to exclude STI, minimise problems with sexual and urinary function, and reduce the risk of cancer of the penis.
A specific causative condition should be identified and treated aggressively. Non-specific balanoposthitis is a diagnosis of exclusion.
Patients will typically present in a primary care setting. Input from specialists, particularly dermatologists and urologists, may be very helpful in the management of poorly responsive or complex cases.
Balanoposthitis refers to inflammation of the glans penis and prepuce. It is a descriptive term rather than a diagnosis. It can be regarded as a special sort of dermatosis that occurs within a skin fold (i.e., an intertrigo). By definition, balanoposthitis cannot occur in a circumcised male, although balanitis (inflammation of the glans penis) might. There are many possible causes of balanoposthitis, and these can be broadly divided into inflammatory, infective, and pre-cancerous.
History and exam
- multiple sexual partners
- high-risk sexual behaviours
- post-inflammatory hypo- or hyper-pigmentation
- red scaly patches
- personal/family history of atopy (eczema, hay fever, asthma, type I allergies)
- personal/family history of psoriasis
- urinary dribbling
- red plaques
- papules or micro-papules
Ien Chan, MD, FRCP
Chelsea and Westminster Hospital
IC declares that he has no competing interests.
David Hawkins, FRCP
Consultant Genitourinary Physician
Chelsea and Westminster Hospital
DH declares that he has no competing interests.
Christopher Bunker, MA, MD, FRCP
Honorary Professor of Dermatology
University College London
Chelsea & Westminster Hospitals
CB is the owner and CEO of Bruce Shrink Ltd., the publisher of Male Genital Skin Disease, an e-book authored by CB. CB lecturers frequently on balanoposthitis, is in receipt of grants to research the topic, and occasionally provides expert testimony on the topic. He is an author of a number of references cited in this topic.
Colm O'Mahony, MD, FRCP, BSc, DIPVen
Consultant in Sexual Health
Department of Sexual Health
Countess of Chester Hospital NHS Foundation Trust
CO declares that he has no competing interests.
Sarah Edwards, MD
Department of GU Medicine
West Suffolk Hospital
SE declares that she has no competing interests.
David Paige, MD
Consultant Dermatologist and Honorary Senior Lecturer
The Royal London Hospital
DP declares that he has no competing interests.
Jashin Wu, MD
Chief Dermatology Resident
University of California
JW declares that he has no competing interests.
Christopher Huston, MD
Assistant Professor of Medicine
Division of Infectious Diseases
University of Vermont College of Medicine
CH declares that he has no competing interests.
Nanette Silverberg, MD
Clinical Professor of Dermatology
Columbia University College of Physicians and Surgeons
New York City
NS declares that she has no competing interests.
Julian Trevino, MD
Associate Professor of Dermatology and Dermatology Residency Program Director
Boonshoft School of Medicine
Wright State University
Speaker's Bureau, Stiefel; Consultant, Abbott.
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