1, symptoms of balanitis prepuce
1, acute superficial balanitis prepuce
It is often caused by local physical factors such as excessive prepuce or poor turnover, trauma, friction, condoms, soap and detergent. The clinical manifestations are local edematous erythema, erosion, exudation and bleeding, and blisters may appear in severe cases. After secondary bacterial infection, purulent secretions are formed on the ulcer surface. The above symptoms can be aggravated by local friction, or by poor foreskin turnover and secretion accumulation to stimulate the wound. The conscious symptom is local pain, which is more obvious after rubbing, and the patient feels inconvenient to move. Significant local inflammation can be accompanied by mild systemic symptoms, such as fatigue, fatigue, low fever, inguinal lymphadenopathy and so on. This type should be distinguished from fixed drug eruption.
2. Circumferential ulcerative balanitis
Clinically, it can exist independently, or it can be a mucosal symptom of Reiter's disease. The clinical manifestations are erythema of glans penis and foreskin, which gradually expands into one or more rings, and then forms superficial ulcer surface. People with poor foreskin turnover are often infected by the accumulation of local secretions, and then lose the ring characteristics, which is not easy to distinguish from superficial foreskin balanitis.
3, candidal foreskin balanitis
It can be primary or secondary. The latter is often secondary to diabetes, senile wasting disease, antibiotic and hormone therapy, or the spouse has candidal female genital inflammation. The clinical manifestations are erythema, smooth surface, slight desquamation at the edge, satellite-like distribution of papules and pustules, slow expansion around, and generally clear boundaries. At the time of acute attack, the glans mucosa is erythema and edema, with unclear boundary and sometimes erosion and exudation. Candida can be found by direct microscopic examination and culture of the lesion site. Sometimes the glans penis is allergic inflammation caused by candida infection. In this case, the pathogen test is usually negative. Recurrent candidal balanitis of prepuce can cause chapped prepuce, fibrosis and sclerosing changes of glans.
4, plasma cell balanitis prepuce
Middle-aged patients are more common, with single or multiple localized dark erythema blocks, which last for a long time and fade slowly. The surface is smooth, peeling or wet, with obvious infiltration, clear edge and no ulcer. Sometimes it looks like hyperplastic erythema of glans penis. Pathological changes have diagnostic value, such as epidermal cell proliferation, flat epidermal process, infiltration of a large number of plasma cells in dermis, telangiectasia and hemosiderosis.
5, amebic foreskin balanitis
This disease is rare. The patient's original balanitis foreskin caused the skin to lose its normal barrier function, and on this basis, the infection of intestinal amebiasis caused balanitis foreskin. The clinical manifestations are infiltration, erosion, ulcer and obvious tissue necrosis. The secretion can be directly smeared to find amoeba.
6, mica and keratinized pseudoepithelioma foreskin balanitis
The clinical manifestations are infiltration and hypertrophy of glans rash, local hyperkeratosis, and mica scab on the skin, which is silvery white. With the passage of time, the glans penis lost its normal elasticity and showed atrophic changes. Pathological changes showed hyperkeratosis, spinous hypertrophy, prolonged epidermal processes and pseudoepithelioma-like hyperplasia. Chronic inflammatory cell infiltration in the upper dermis. This change is epithelial hyperplasia caused by inflammation, not malignant transformation.
7. Trichomonas foreskin balanitis
It is a mild and temporary foreskin erosive balanitis with or without urethritis. At the beginning, papules and erythema appeared on the glans penis, the scope gradually expanded and the boundary was generally clear. On the erythema, I saw a small blister as big as a needle and a millet. After that, the blisters expanded and merged with each other to form a slightly rotten surface. Trichomonas can be found in secretions.
2. Etiology of balanitis prepuce
Balanitis prepuce is a common disease. The balanitis prepuce is divided into wrapping dermatitis and balanitis, which are called Tintin balanitis prepuce because they often appear at the same time. This kind of inflammation can be infectious or non-infectious, and infectious balanitis prepuce is more common in clinic.
Balanitis prepuce can be caused by infection or non-infection. Because of unclean sexual intercourse, infection with Candida albicans, trichomonas, chlamydia, mycoplasma, gonorrhea and gonococcus can all cause balanitis prepuce. Non-infectious factors are mostly because the foreskin is too long and the cleaning is not enough. Dirty things between the foreskin and the glans penis, that is, scale, will accumulate and stimulate local inflammation of the foreskin and mucosa. Balanitis prepuce is also caused by local physical factors such as excessive prepuce or poor turnover, trauma, friction, condoms, soap and detergent.
3, foreskin balanitis is the most effective treatment.
1. Keep local cleanliness to prevent secondary infection. Iodine fluoride solution can be used externally, and anti-inflammatory ointment can also be used. Allergic prepuce balanitis requires oral antiallergic drugs and topical pine ointment.
2. Infiltration erosion can be wet-packed with 3% boric acid water or 0. 1% sodium fluoride.
3. Non-infectious subacute patients can use corticosteroid cream.
4. For chronic or dry desquamation, tetracycline cortisone ointment can be used.
5. The infection is obvious, and the fever and lymphadenopathy are obvious. Antibiotics such as cefalexin or fluorozinic acid can be used all over the body.
6. Circumcision of foreskin: If phimosis or foreskin edema cannot be reversed and the drainage is not smooth, the inflammation cannot subside after general treatment, and dorsal incision of foreskin is feasible to facilitate drainage. Circumcision should be performed after the inflammation has completely subsided.
4. Misunderstanding of the treatment of balanitis prepuce.
1, blind medication: When the private parts are found to be red and swollen, disinfection and anti-inflammatory cleaner is often used to clean Tintin's foreskin and glans skin, which causes strong chemical stimulation to the local skin, swelling and exudation, and aggravates the acute inflammation of balanitis. If acute inflammation is not handled properly, it is easy to recur, and eventually it can form chronic balanitis prepuce, leading to balanitis sicca obliterans, causing sexual dysfunction and seriously affecting the quality of life of couples.
2. Feel free to see a doctor: When balanitis occurs, many patients think it is a sexually transmitted disease. Because I am ashamed to go to a regular hospital, I go to a small clinic or a quack. Irregular treatment and medication will not only aggravate the condition, but also delay it.
3. Neglect of disease: Due to the high incidence of balanitis prepuce and mild initial symptoms, it is easy to be ignored in daily life, accompanied by complications and complications when visiting a doctor, which has caused great damage to the reproductive health system.
4, the cause is not clear: the foreskin is too long, which is one of the important factors for the onset and repeated healing of foreskin balanitis. If the foreskin is too long to be treated, germs and inflammatory secretions are easy to hide in the foreskin, which directly acts on the lesion or new tissue structure, aggravating the condition. Therefore, if the foreskin is too long, it needs early treatment.
5. Non-standard treatment: Clinical non-standard treatment makes the disease relapse. At the same time, due to the long course of balanitis prepuce, the irregular use and abuse of antibiotics, bacteria are prone to drug resistance. , making the traditional treatment can not achieve the ideal effect. Long-term chronic inflammation has an impact on urogenital health, resulting in prostatitis, impotence, premature ejaculation and other diseases.
6. Factors such as too long foreskin are easily overlooked: too long foreskin is also an important factor for the onset and recurrence of balanitis prepuce. If the foreskin is too long to be treated, germs and inflammatory secretions are easy to hide, which directly act on the diseased parts or new tissue structures in the foreskin, aggravating the disease or causing lesions.
5. Prevention of balanitis prepuce
1. The way to prevent and care for balanitis is to pay attention to local hygiene and clean the glans and foreskin every day. If the foreskin is too long, it should be treated in time and circumcised if necessary. It is necessary to clean up the scale in time.
2. If the husband and wife suffer from sexual organ diseases, they should suspend their sexual life and treat them in time. If you have trichomoniasis or candida albicans infection, you should treat it at the same time.
3. Avoid unclean rooms and lead a totally clean life. If there is ulcer or erosion, dressing should be changed in time, twice a day, to avoid uncomfortable stimulation. For acute prepuce balanitis, corticosteroid ointment should be avoided to avoid causing more serious infection.
4, often clean the foreskin and Tintin head, keep the foreskin cavity clean and dry, dermatitis can be completely prevented. At ordinary times, we should pay attention to develop good hygiene habits. Circumcision of the foreskin that is too long or phimosis (the foreskin can't be turned over) has a good preventive effect. If this disease is found, the foreskin will be turned over, washed with potassium permanganate solution and properly applied with antibiotics, and it will be fine within a few days. If it is serious, it needs effective treatment under the guidance of a doctor.