Now the very first thing that we have to do is exclude the possibility of paraphimosis. Like we said, this is a urological emergency and we really don’t want to miss this diagnosis. Now once we’ve excluded that possibility, the next step is to really do a history in a physical.
And we can really diagnose contact dermatitis, poor hygiene and Candida infection (balanitis candidiásica) on clinical grounds. These are fairly easy to diagnose and go ahead and start the patient on treatment as appropriate (tratamiento para la balanitis).
For those cases that are not quite so clear then we probably want to do some type of laboratory testing. Things are going to include
– glucose screening to make sure we don’t have diabetes,
– microscopy and we’re going to want to do a
– chlamydia and
– gonorrhea screening on certain patients as well.
Bacterial cultures really add little to the diagnosis but like we said if you’re uncertain of the etiology (balanitis causas) go ahead and get a bacterial culture also consider getting a group a strep culture like we said strep is a possible etiology strep can be transmitted orally, through oral sex so we have to make sure that that’s not the reason the patient is presenting with balanitis, also be on the lookout for inverse psoriasis.
Inverse psoriasis presents a little bit differently than the classic presentation of psoriasis this is going to be noted in the intertriginous areas and it’s not going to have the scaling or the silver plaques that are going to be normally associated with classic psoriasis, so inverse psoriasis also scabies HPV (hpv balanitis).
These types of infections are also going to present with papules and it’s also going to present with balanitis like symptoms (balanitis sintomas). Lastly we want to look for lichen planus. now lichen planus can present on the genital area and it’s going to present with vaiolaceous papules that are present over the glans.
So these are different possible etiologies that might resemble balanitis. these last few things here, we want to exclude these as the possible differential diagnosis. Moving on to the
Treatment of Balanitis (balanitis tratamiento or tratamiento para la balanitis):-