balanoposthitis

Balanoposthitis is the inflammation of the glans penis (balanitis) and the foreskin (posthitis), most commonly affecting uncircumcised men. It presents with redness, swelling, itching, pain, and sometimes discharge or foul odor. In infants and children, it can cause irritability and difficulty with urination or hygiene.

Causes and risk factors include infections (most often fungal Candida species or bacterial pathogens), irritation from soaps, detergents, or latex, and allergic contact dermatitis. Additional contributing factors are poor hygiene, phimosis (inability to retract the foreskin), diabetes mellitus, immunosuppression, and skin conditions such as eczema or lichen sclerosus. Sexually transmitted infections can be involved but are less common causes of balanoposthitis.

Diagnosis is usually clinical, based on history and physical examination. Swabs or urine tests may be performed to identify infection and guide treatment. In adults, screening for diabetes or other underlying conditions may be considered if recurrent balanoposthitis occurs. Differential diagnoses include penile dermatitis, dermatologic conditions affecting the genital skin, or infections not limited to balanoposthitis.

Treatment depends on the cause. General measures include improved hygiene and avoidance of irritants. For candidal infection, topical antifungals (eg, azoles) are commonly used. Bacterial balanoposthitis may require topical or sometimes systemic antibiotics. If there is an inflammatory skin condition, short courses of topical corticosteroids may help, but care is needed in the genital area. Recurrent cases may prompt discussion of definitive measures, such as circumcision in select individuals. Complications are rare but can include phimosis or secondary infections.

Prevention focuses on good genital hygiene, avoiding irritants, managing diabetes, and addressing risk factors to reduce recurrences.