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PubMed1975

Balanitis xerotica obliterans in children.

Balanitis xerotica obiterans is a chronic inflammatory process in male subjects, resulting in sclerotic epithelial changes of the glans penis, prepuce and urethral meatus individually or collectively. Four pediatric cases are presented, including the first case of balanitis xerotica obiterans invloving the glans penis and urethral meatus in a child. This lesion may be misdiagnosed or ignored in the young boy. The suggested method of treatment is surgical extirpation of the lesion when possible, wedge meatotomy when needed and sublesional corticosteroids if the lesion cannot be completely excised.

Balanitis↗
PubMed2005

Balanitis xerotica obliterans in boys.

PURPOSE: Balanitis xerotica obliterans (BXO) is a chronic dermatitis of unknown etiology most often involving the glans and prepuce but sometimes extending into the urethra. We report our 10-year experience with BXO in pediatric patients. MATERIALS AND METHODS: Our pathology database was queried for all tissue diagnoses of BXO from 1992 to 2002. Available charts were reviewed and patient presentation, clinical and referral history, operative procedure(s) and postoperative course were recorded. RESULTS: A total of 41 patients had a tissue confirmed diagnosis of BXO. Median patient age was 10.6 years. Of the patients 85% were 8 to 13 years old and all had referrals available for review. The most common referral diagnoses were phimosis (52%), balanitis (13%) and buried penis (10%). No patient had the diagnosis of BXO at referral. Of the patients 19 (46%) underwent curative circumcision or redo circumcision and had no recurrence at a mean followup of 12.5 months (range 1 to 57). A total of 11 patients (27%) had BXO involvement of the meatus and underwent circumcision combined with meatotomy or meatoplasty. Nine patients (22%) required extensive plastic operation(s) of the penis, including buccal mucosa grafts in 2. CONCLUSIONS: The incidence of BXO in pediatric patients may be higher than previously reported, with the diagnosis rarely made by pediatricians. Our study demonstrates that older patients, those with BXO involvement of the meatus and those with a history of surgery for BXO tend to have a more severe and morbid clinical course.

Balanitis↗
PubMed1987

Is pseudoepitheliomatous, micaceous and keratotic balanitis synonymous with verrucous carcinoma?

Two cases of pseudoepitheliomatous, micaceous and keratotic balanitis are presented and their clinical and histological features are discussed. This rare condition of the glans penis was originally thought to be benign, but more recent evidence indicates that the lesion is a manifestation of verrucous carcinoma. Consequently, the treatment of choice is excision with a wide margin. We suggest the new name, micaceous and verrucous malignant balanitis.

Aged↗
PubMed2005

Plasma cell balanitis treated with tacrolimus 0.1%.

BACKGROUND: Plasma cell balanitis or balanitis of Zoon (BZ) is a frequent diagnosis in mature men and lesions are generally localized on the glans but may involve the prepuce; its aetiology remains unknown. OBJECTIVES: To present our experience with tacrolimus 0.1% ointment in the treatment of two patients with BZ refractive to other topical treatments. PATIENTS AND METHODS: Two uncircumcised mature caucasian males were seen, both presenting with BZ; topical tacrolimus 0.1% ointment twice daily was prescribed in each case. RESULTS: Marked improvement of the lesions in both patients has been observed, with follow-up of 1 year and 10 months, respectively. CONCLUSIONS: Topical tacrolimus 0.1% ointment is an effective and safe treatment for BZ.

Aged↗
PubMed1979

Balanitis xerotica obliterans.

Twenty patients with histologically proven balantis xerotica obliterans have undergone different forms of treatment; their progress has been reviewed and discussed. Balanitis xerotica obliterans involving only the foreskin was best treated by circumcision. The patients in whom meatal stenosis was present responded well to regular meatal dilatation, meatotomy followed by regular dilatation and, in advanced cases, to meatoplasty. At present there is no evidence to indicate that associated urethral strictures, proximal to the fossa navicularis, are due to balanitis xerotica obliterans.

Adolescent↗
PubMed1984

Zoon's balanitis treated by circumcision.

Zoon's balanitis is a chronic balanitis affecting parts of the glans penis and prepuce, usually considered refractory to treatment. This article reports the study of seven cases successfully treated by circumcision.

Adult↗
PubMed1978

Clotrimazole (Canesten) in the treatment of candidal balanitis in men. With incidental observations on diabetic candidal balanoposthitis.

Clotrimazole 1% (Canesten) cream was used in a trial comprising 138 men with candidal balanitis. Eighty-six (91%) out of 94 men were asymptomatic after seven days and 57 (98%) of 58 men were asymptomatic after three weeks' treatment. After seven days, Candida albicans could no longer be cultured from 86 (90%) of 96 men, nor from 55 (95%) of 58 men three weeks after treatment. Microscopical examination gave varying results. Fifteen (10.9%) of 138 men were found to have diabetes mellitus; this group was significantly older than the non-diabetics. It is concluded that treatment with clotrimazole for seven days is effective in the treatment of candidal balanitis.

Adolescent↗
PubMed1993

Zoon's balanitis.

Superficial lesions of the glans penis can cause diagnostic difficulties. Zoon's balanitis can be distinguished by characteristic histological changes affecting the epidermis and the dermal vasculature. A 44-year-old male presented after having blood-staining of his underclothes for 5 months. Upon examination, the glans showed a red, moist plaque. Circumcision was performed, and the biopsy showed plasma cell balanitis. Following circumcision, the lesion healed completely.

Adult↗
PubMed1987

Balanitis xerotica obliterans in children.

Balanitis xerotica obliterans was studied in 48 fully developed and 6 early cases in children aged 2-15 years. It occurred in 9% of 100 consecutive circumcisions for all, including religious, reasons and in 19% of 232 other circumcisions for disease of the prepuce and penis. Seven cases developed after surgery for hypospadias. The boys nearly always presented with inability to retract the prepuce; half also had discomfort after micturition, and a quarter had obstructive signs, usually minor. At surgery, half had involvement of glans or meatus, previously considered rare in childhood, 3 requiring meatotomy. The condition, once seen, was easily recognized clinically as well as microscopically. The early cases, characterized by focal narrow hyaline edematous zones in severe diffuse chronic balanitis, suggest that the condition may be an inflammation in which the usual increased permeability of small vessels in inflammatory reaction is accentuated in a loose vascular region.

Adolescent↗
PubMedDate not supplied

Composition of the inflammatory infiltrate in pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans): a prospective, comparative immunophenotyping study.

Dermatopathological evaluation of pediatric preputial inflammatory disease rarely allows for specific diagnosis other than pediatric penile lichen sclerosus et atrophicus (balanitis xerotica obliterans, LSA/BXO). A prospective immunopathological study was performed on 20 consecutive, unselected, clinically and histopathologically confirmed LSA/BXO cases to determine the relative presence of T and B lymphocytes. There were seven cases with early stages of disease, eight with florid disease, and five with later stages of disease. Two ritual circumcision specimens and 12 specimens with non-LSA/BXO balanitis, collected during the same period, were used as controls. The infiltrate in LSA/BXO patients was wholly composed of T cells (positive with UCLH-1 antibody) in all cases. B cells (positive with L-26 antibody) were found only focally in small, discreet, easily recognizable (follicular or early follicle-like) aggregates, positioned slightly deeper than the band-like infiltrate of T cells. T cells were inconspicuous in 9 of the 12 control specimens. In the three other controls, T cells were much more obvious and these patients showed clinical features possibly suggestive of LSA/BXO in early, prediagnosable phases of development. We conclude that limited immunophenotyping may be a useful adjunct to diagnosis in pediatric cases in which only limited tissue is available or the disease may be more difficult to classify with confidence.

Adolescent↗
PubMed2000

Bowen's disease of the glans penis (erythroplasia of Queyrat) in plasma cell balanitis.

We report a case of a persistent penile plaque on the glans penis of allegedly more than 20 years' duration, which was refractory to circumcision and local treatment. Over the years, the patient repeatedly presented with a circumscribed inflammatory lesion of the glans penis, diagnosed as Zoon's balanitis on the basis of clinical aspects and two biopsies. Because of unresponsiveness of the lesion to circumcision and focal steroid infiltration, repeated biopsies were performed in an attempt to rule out malignancy. Two further biopsies were carried out. One again showed the features of a plasmacellular inflammation, while the other finally revealed the histopathologic features of erythroplasia of Queyrat (carcinoma in situ or Bowen's disease of the glans penis). We assume that either the former biopsy specimens were taken from a plasma cell-rich reactive infiltrate around the neoplastic lesion, or that carcinoma in situ may have arisen due to the chronic inflammation of Zoon's balanitis plasmacellularis. Radiotherapy was performed with good clinical response and subsequent histopathologic proof of complete remission of the lesion.

Aged↗
PubMed1975

[Variable pseudoerythroplasic telangiectasis balanitis].

This is a special case of balanitis, that authors separate from entities clinically established such as Erthroplasie of Queyrat, Balanitis of Zoon, Liquenoide Balantis with Plasmocytes and the Balantis of Sulsberger and Garbe's illness. The V. P. T. B. is clinically characterized by the presence of telangiectasies, ertroplasiform aspect, without any infiltration, non purpure, the V. P. T. B. goes through a first period truly esythematous and a second one in which these is also desquamation. That cycle is completed in a month. At the histopathologic level, the most important characteristics are: epidermis with its Malpighian layer in a normal state, the basal layers showing hidropic degeneration. The repper dermis shows a lichenoid picture that, in certain places affects the basal layer. The infiltrate is composed of: lymphocytes, monocytes and plasmocytes. Numerous telangiectasies are also observed.

Adult↗
PubMed1991

Group A beta-hemolytic streptococcal balanitis: it may be more common than you think.

Group A beta-hemolytic Streptococcus can cause balanitis in prepubertal males, and its incidence is probably greater than previously reported in the pediatric literature. We suggest the routine inclusion of a GABHS-selective culture in any case where a discharge or irritation is present on the glans or foreskin, especially if a recent streptococcal infection has been documented, whether or not sexual abuse is being considered. Finally, we hope to stimulate interest for further in-depth study of balanitis caused by GABHS.

Balanitis↗
PubMed1988

Pseudoepitheliomatous, keratotic, micaceous balanitis. A clinical lesion with two histologic subsets: hyperplastic dystrophy and verrucous carcinoma.

A 58-year-old man presented with a 4-year history of a slowly enlarging, hyperkeratotic plaque on his glans penis that was compatible with a clinical diagnosis of pseudoepitheliomatous, keratotic, micaceous balanitis. The lesion had been treated unsuccessfully on three occasions with superficial shave excisional biopsies. Complete surgical excision produced excellent cosmetic and functional results with no evidence of recurrence at 3- and 6-month follow-up. A diagnosis of verrucous carcinoma was made on histologic examination of the excised material. Pseudoepitheliomatous, keratotic, micaceous balanitis is a distinctive clinical entity that represents a histologic spectrum ranging from hypertrophic-hyperplastic penile dystrophy to verrucous carcinoma.

Balanitis↗
PubMed1977

Pseudomonal balanitis.

Significant ecologic changes in the cutaneous flora during treatment may present a challenge both diagnostically and therapeutically. The development of an erosive balanitis due to Pseudomonas aeruginosa presented an example of such a microbiologic shift in the case reported. The eruption developed during treatment with topical antibacterial, antifungal, and corticosteroid agents. The sudden exacerbation of any balanitis while under treatment should alert the physician to the possibility of superinfection.

Adult↗
PubMed1975

Circinate erosive balanitis and HL-A 27.

The HL-A phenotype of 17 patients with a typical clinical picture of circinate erosive balanitis was determined. Eight of the patients had other signs of Reiter's disease and 9 had balanitis alone. HL-A 27 was found to be present in 15 of the 17 cases. One patient of each group lacked this antigen. The frequency of the other histocompatibility antigens did not significantly differ from that of a Finnish control population.

Adolescent↗
PubMed1993

Histopathological and immunological studies in a cohort of balanitis xerotica obliterans.

Balanitis xerotica obliterans consisting of 52 cases had been studied in the present series. This disease entity is an insidious sclerosing disease of unknown aetiology, affecting mainly the skin and mucous membrane of glans, prepuce and sometimes the fossa navicularis urethrae or even terminal urethra. Atrophic white patches on external genitalia and obstructive uropathy are two common presenting features. It has been classified as local form of lichen sclerosus et atrophicus. Poor local hygiene, circumcision and association of auto-immune diseases like vitiligo are responsible as suggested in this study. Routine tests detected associated cystitis in 8 cases, haematuria in 4 cases, non-reactive VDRL in all cases and impaired glucose tolerance in 5 cases. Immunoglobulin profile (39 cases) showed altered pattern, suggesting some chronic antigenic stimulation. Out of 33 cases where biopsy done, histologically proved typical balanitis xerotica obliterans was found in 19 cases. Malignant change was noted in one case only. Circumcision and dilatation offered temporary relief.

Adolescent↗