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We report the 2nd case of titanium balanitis reported in the world literature. Clinically the patient presented with phimosis: histologically the titanium was surrounded by a mixed granulomatous inflammatory reaction. Topical titanium preparations may lead to phimosis and therefore we thought it important to bring this potential iatrogenic complication to further notice.
A case of pseudoepitheliomatous, keratotic and micaceous balanitis (PEKMB) in a 64-year old man is presented. The patient presented with the 2-year history of a slowly enlarging, hyperkeratotic plaque on his glans penis that was compatible with a clinical diagnosis of PEKMB. The lesion has been treated successfully with tropical 5-fluorouracil cream, with no evidence of recurrence at 2-year follow-up. Histological examination revealed acanthosis, hyperkeratosis, and pseudoepitheliomatous hyperplasia with no cytological atypia. This rare penile condition was considered pseudomalignant, premalignant, or as a low-grade squamous malignancy. Apart from this patient we comprehensively review previously reported cases, and discuss a possible concept on etiology, diagnosis and treatment of this entity.
A clinical report of 5 cases of balanitis xerotica obliterans (BXO) with urethral involvement is presented. Involvement of the urethra in the BXO is emphasized and the fact that this process is often unnoticed, is stressed. The clinical and histological characteristics of this disease are described in its different localizations. Investigations are suggested to diagnose urethral involvement and the suitable therapy is outlined.
Streptococcus pyogenes (the Lancefield group A streptococcus) is a cause of pharyngitis and impetigo. However, it has rarely been implicated as a sexually transmitted pathogen. We herein report two cases of severe balanitis due to S. pyogenes in sexually active men. It is postulated that penile cellulitis developed following the invasion of S. pyogenes through a traumatic abrasion acquired during fellatio performed by commercial sex workers. Both patients were treated successfully with oral administration of penicillin.
Squamous cell carcinoma of the penis is an uncommon cancer, though in one study it accounted for 90% of all penile cancers. Its association with balanitis xerotica obliterans (BXO) is a rare though recognized occurrence. We describe a case of a 46-year-old Caucasian male who first presented to our open-access clinic with a mild phimosis. An elective circumcision was performed and histological examination of the circumcision specimen showed BXO. He was lost to follow-up but re-presented three years later with a persistent tender penile ulcer which on biopsy showed no obvious sinister pathology. He returned a further two years later with a short history of bleeding from the ulcer, and another biopsy now confirmed penile squamous cell carcinoma. Our case emphasizes the importance of regular review of patients with BXO, in particular those with persistent symptoms.
A typical case of balanitis circumscripta plasmacellularis is described in a 74-year-old man. Electron microscopy revealed a dense infiltrate composed mainly of plasma cells and macrophages; the former showed considerable rough endoplasmic reticulum and phagolysosomes, while the latter contained variable amounts of sideromes. A few mast cells, eosinophils and extravasated erythrocytes were also present. Connective tissue was scarce; no elastic fibres and viral particles were seen.
A 48-year-old, uncircumcised man presented with plasma cell balanitis, which is a chronic, erosive dermatitis at the glans penis and the inner surface of the prepuce, which is normally treated by circumcision. He was treated with three sessions of copper vapour laser over a period of three months and apart from a minor relapse after seven months he has to our knowledge been well.
The in vitro activities of enrofloxacin, florfenicol, oxytetracycline and spiramycin were determined against field isolates of Mycoplasma mycoides mycoides large colony (MmmLC) by means of the broth microdilution technique. The minimum inhibitory concentrations (MICs) of these antimicrobial drugs were determined for a representative number of 10 isolates and 1 type strain. The susceptibility of Arcanobacterium pyogenes to enrofloxacin, oxytetracycline and tilmicosin was determined by means of an agar disk diffusion test. The MICs of enrofloxacin, florfenicol, oxytetracycline and spiramycin were within the ranges of 0.125-0.5, 1.0-2.0, 2.0-4.0 and 4.0-8.0 microg/ml, respectively. This study has shown that resistance of MmmLC against enrofloxacin, florfenicol, oxytetracycline and spiramycin was negligible. All the field strains of A. pyogenes that were tested were susceptible to enrofloxacin, oxytetracycline and tilmicosin with mean inhibition zones of 30.6, 42.3 and 35.8 mm, respectively. Although there is lack of data on in vivo efficacy and in vitro MIC or inhibition zone diameter breakpoints of these antimicrobial drugs for MmmLC, the MIC results indicate that these 4 classes of antimicrobial drugs should be effective in the treatment of ulcerative balanitis and vulvitis in sheep in South Africa.
A case of pseudoepitheliomatous, keratotic, and micaceous balanitis in a 69-year-old white man is presented. This report supports the notion that this condition is a localized form of verrucous carcinoma which tends to be resistant to treatment and to recur locally. Treatment with topical fluorouracil cream was partially effective but follow-up studies were not available because the patient died of lung cancer. This appears to be only the third reported case of this condition in the English literature.
One case of plasma-cell balanitis of Zoon is reported. An excellent therapeutic result was obtained by means of the circumcision. A review of the disease is made, with special attention in the clinical and histological differential diagnosis, and the last contributions in electronic microscopy are commented.
Balanitis xerotica obliterans (BXO) and kraurosis penis are thought to be synonymous. Clinically and histopathologically they probably represent the same disease process as lichen sclerosus et atrophicus (LSA) but also involve the urethral mucosa. The treatment of choice is considered to be 2 1/2% testosterone propionate ointment which gives better results than strong corticosteroid applications, yet without their side effects.
A case of pseudoepitheliomatous, keratotic, and micaceous balanitis is described. This rare tumor of the glans penis was initially considered to be entirely benign. Evidence from this case and from previously published case reports suggests that this lesion may have locally invasive or aggressive tendencies and that it should be considered to have low-grade or limited malignant potential. Conservative surgical removal seems to be adequate therapy.
We report six cases of plasma cell balanitis and four of plasma cell vulvitis. The patients' ages ranged from 26-88 years in males and 30-60 in females. All the men were uncircumcised and presented with a discharge and erythematous lesions on the glans penis and prepuce. In females the main presenting complaints were vulvar soreness, pruritus, smarting/burning, discharge and bleeding. Two were on hormone replacement therapy, two had undergone a mastectomy for carcinoma of the breast, and one was an insulin-dependent diabetic. Another patient subsequently developed diabetes mellitus. Topical and intralesional corticosteroid preparations resulted in satisfactory improvements in all cases, male and female. Two males subsequently underwent circumcision, which was curative.
A peculiar anatomoclinic form is described about the Balanoposthite chronique circonscrite bénigne à plasmocytes (Zoon): the pimpled, erosive, nodular and pseudoangiomatous form. Clinically this balantis realizes a pseudo-oedematous infiltration (which belongs to the usual form) and especially botriomycome-like nodules (obs. 2) or pseudo-neoplastic tumors (obs. 1). Histologically, the lesions consist of a pure plasmocytar infiltration, with total disappearance of the epithelium. In spite of its pseudo-tumoral aspect and of the abundance of plasmocytes, this kind of balanitis is quite benign and chronic, may persist many years without transformation, and is never a sign of dysglobulinemia.
The Barcat balanic groove technique for the repair of distal hypospadias creates a neourethra with a ventral penile skin flap and a ventral glandular flap, both of which are based at the meatus. A series of 105 consecutive patients with distal hypospadias operated on by the same surgeon is presented. The primary complication was fistula formation in 15 per cent of the patients.
A personal technique is described for the surgical correction of balanic hypospadias. The result of this technique is a large neourethra and satisfactory esthetics in 1 operation.
The purpose of this study was to determine whether the Balans Multi-Chair (BMC) approximates the amount of standing lumbar curve better than a standard conventional chair (SCC) in seated subjects writing at a desk. The length of the curve from L1 to S2 was measured with a flexible ruler in 44 healthy subjects who were standing and sitting on both an SCC and a BMC. A one-way analysis of variance for repeated measures and the Student-Newman-Keuls test were used to examine the differences in the curves created in the three positions. The frequency of subjects sitting in lumbar flexion was compared using a chi-square test with those not in flexion. Lumbar curves measured in the three positions were significantly different (p less than .01). The BMC approximated the standing lumbar curve in seated subjects writing at a desk to a greater degree than the SCC. In addition, the BMC produced lumbar flexion less frequently (chi 2 = 4.33, p less than .05) than did the SCC. These data suggest that the BMC may be an appropriate adjunct in client care when minimal lumbar flexion or lumbar extension is indicated.
The observation of a balanic hypospadia with chordee associated with a renal malformation in both of identical twins is reported. Monozygosity of twins was demonstrated with the study of ABO, MNS, HLA and RH factor systems. Urography, performed in both twins, showed a specular crossed renal ectopia with fusion. Abdominal ultrasounds, Chest-X-ray and barium meal showed no other abnormalities. After an analysis of the embryogenetic mechanisms of twinning, the Authors elaborate a hypothesis to explain the development of this specular renal malformation, never reported up to date in identical twins.