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Giornale Italiano di Dermatologia e Venereologia 2000 October;135(5):585-92

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Infective balanitis and balanoposthitis

D’Antuono A., Cocci C., Carlà E., Bardazzi F., Varotti C.

Dipartimento di Medicina Clinica Specialistica e Sperimentale Sezione di Clinica Dermatologica (Prof. C. Varotti.)

Balanitis and posthitis are defined respectively as inflammations of the glans penis and the prepuce. These are common conditions and can be occasional, recurrent or persistent.
There is a wide variety of causes (irritations, trauma, infections) and predisposing factors (uncircumcised men, systemic diseases as diabetes mellitus, poor hygiene).
The infective causes seem to be the most common, but there are few studies about this. Therefore the infective balanitis and balanoposthitis cause diagnostic, ethiologic and therapeutic problems.
Many micro-organisms are associated with balanitis and posthitis:
—mycotic infections: Candida spp. is considered to be the most common cause of balanitis, but also dermathophytes and less common mycetes;
—bacterial infections: anaerobes (particularly Bacteroides spp.), but its pathogenic role is not defined; aerobes mostly Streptococcus B, but also Staphylococcus aureus, Gardnerella vaginalis and other uncommon bacteria, besides Chlamydia, Neisseria and Spirochetes;
—protozoan infections: Trichomonas vaginalis;
—parasitic infections: Sarcoptes scabiei, Entamoeba histolytica.
Diagnosis and therapy are often empiric for some of these balanitis and balanoposthitis (particularly bacterial infections), frequently they turn into chronic and often there are recurrences; moreover it is important to evaluate the psychological factor. The only clinical characteristics are not adequate, so it is very difficult to achieve an ethiologic diagnosis. In fact, there are real doubts about the pathogenic role of many micro-organisms and often the relationship between clinical characteristics and laboratory examinations are not significant.