Deterrence/Prevention
- Prevention has centered on improved hygiene of the prepuce.
- Although circumcision has been advocated for refractory or recurrent cases, this is now primarily used if improved drying and hygiene are not effective.
Prognosis
- The outcome is often favorable, with treatment failures often leading to further clinical examination and tailoring of the treatment to the particular offending agent.
- Failure of response in the setting of appropriate treatment should raise the suspicion of malignancy. This necessitates a biopsy to rule out both primary malignancies and secondary malignancies involving the penis. The most common malignancy that mimics balanoposthitis is erythroplasia of Queyrat, although Bowen disease may have some clinical overlap. A single case report has described the presentation of acute promyelocytic leukemia as an ulcerating balanoposthitis.[32]
- In a patient who is immunocompromised, the presence of a systemic fungal infection can lead to involvement of the penis and often arises as a more deeply involved ulcerating lesion. Treatment of this disease, which can be caused by any number of fungal agents, involves clearing the systemic infection and immunodepression.
Patient Education
- For excellent patient education resources, visit eMedicine's Men's Health Center. Also, see eMedicine's patient education articles Foreskin Problems and Circumcision.
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