eMedicine Specialties > Dermatology > Reactive & Inflammatory Dermatoses

Balanoposthitis: Follow-up

Author: Vladimir O Osipov, MD, Assistant Professor, Department of Pathology, Section of Bone and Soft Tissue Pathology, Section of Gastrointestinal Pathology, Medical College of Wisconsin
Coauthor(s): Scott M Acker, MD, Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham; Peter Langenstroer, MD, Associate Professor, Department of Urology, Medical College of Wisconsin; Milton W Datta, MD, Assistant Professor, Departments of Pathology, Urology, and Hematology-Oncology, Emory University School of Medicine
Contributor Information and Disclosures

Updated: Mar 30, 2009

Follow-up

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.28
  • 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

Miscellaneous

Medicolegal Pitfalls

  • Although limited, the major source of risk is associated with the failure to diagnose an underlying malignant or premalignant state, such as erythroplasia of Queyrat. This usually occurs in cases that are refractory to treatment, and, for this reason, failure of the condition to respond to treatment should result in a biopsy to rule out an underlying malignancy.
 


More on Balanoposthitis

Overview: Balanoposthitis
Differential Diagnoses & Workup: Balanoposthitis
Treatment & Medication: Balanoposthitis
Follow-up: Balanoposthitis
Multimedia: Balanoposthitis
References
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References

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Further Reading

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Keywords

balanoposthitis, inflammation of the foreskin and glans, glans penis inflammation, foreskin inflammation

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Contributor Information and Disclosures

Author

Vladimir O Osipov, MD, Assistant Professor, Department of Pathology, Section of Bone and Soft Tissue Pathology, Section of Gastrointestinal Pathology, Medical College of Wisconsin
Vladimir O Osipov, MD is a member of the following medical societies: American Society for Clinical Pathology, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Coauthor(s)

Scott M Acker, MD, Associate Professor, Director of Dermatopathology, Departments of Dermatology and Pathology, University of Alabama at Birmingham
Scott M Acker, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society for Clinical Pathology, and Southern Medical Association
Disclosure: Nothing to disclose.

Peter Langenstroer, MD, Associate Professor, Department of Urology, Medical College of Wisconsin
Peter Langenstroer, MD is a member of the following medical societies: American Urological Association
Disclosure: Nothing to disclose.

Milton W Datta, MD, Assistant Professor, Departments of Pathology, Urology, and Hematology-Oncology, Emory University School of Medicine
Milton W Datta, MD is a member of the following medical societies: College of American Pathologists and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Medical Editor

Abdul-Ghani Kibbi, MD, Chairman and Professor, Department of Dermatology, American University of Beirut Medical Center, Lebanon
Disclosure: none None None

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey Meffert, MD, Assistant Clinical Professor of Dermatology, University of Texas Health Science Center-San Antonio
Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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