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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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eMedicine

 

End of Penis and scrotum > Infectious disorders > Balanoposthitis

 

 

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