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Penis and scrotum
Infectious disorders
Balanoposthitis
Reviewers: Antonio Cubilla, M.D. and Alcides Chaux, M.D. (see Author/Reviewers page)
Revised: 17 February 2010, last major update February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Infection of glans and foreskin, usually due to Candida, Staph, Strep, Garderella, anaerobes, pyogenic bacteria (Acta Derm Venereol 2008;88:331)
Epidemiology
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● Common in uncircumcised newborns or uncircumcised men with poor hygiene and accumulation of smegma
● May be due to poor hygiene, sexual transmission or associated with dermatologic disorders
Etiology
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● Due to propensity of pathogenic bacteria to adhere to inner mucosal surface of foreskin
● Often sexually transmitted in adults (Hinyokika Kiyo 2005;51:737)
● Also sexually transmitted for adults with Candida albicans, with pathogenicity concentrated to a few genotypes (Clin Infect Dis 2008;47:1119)
Clinical features
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● Causes phimosis
● Malassezia is commonly cultured, but at same rate as in controls (Acta Derm Venereol 2008;88:331)
Case reports
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● Caused by Pseudomonas aeruginosa in neutropenic boys (Int J Infect Dis 2009 Aug 3 [Epub ahead of print])
● 58 year old man with granulomatous balanoposthitis after intravesical bcg for bladder cancer (Int J Urol 2006;13:1361)
Treatment
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● Antibiotics, based on empiric anti-fungal therapy (Candida is most common cause) or culture (Int J Dermatol 2009;48:121)
Clinical images
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Marked ulceration with tissue destruction Red eroded rash on glans and
suggesting neoplasia (from Genital skin distal shaft
disorders:diagnosis and treatment,
Mosby 1998:41)
Micro description (Histopathology)
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● Non-specific inflammatory infiltrate with lymphocytes, plasma cells and macrophages
● Causative agent usually not discernable by routine examination
● Epithelial changes such as squamous hyperplasia and ulceration can be associated with inflammation
● Fungal hyphae may be present
Micro images
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Lymphoplasmacytic infiltrate and
dilated blood vessels
Positive stains
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● PAS/GMS for fungi
Additional references
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End of Penis and scrotum > Infectious disorders > Balanoposthitis
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