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Male Genital Lesions

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Balanitis in children
Balanitis may be an acute or chronic problem with inflammation of the glans penis and which may also involve the foreskin. Children may present with a history of a few days of itching or soreness, some exudate and on examination the glans and foreskin may be inflamed and swollen. A swab from under the prepuce for culture and sensitivities may help to identify a causal infection. The yeast Candida or bacterial infections Staphylococcus aureus or Group A beta-haemolytic Streptococcus are the most common invaders. Balanitis may be related to lack of hygiene, such as an infrequently changed nappy; contact with irritants such as detergents; bubble baths or creams; trauma; or skin conditions such as eczema. Management involves attention to hygiene, gentle cleansing of the penis, without attempting to retract the foreskin, topical one per cent hydrocortisone cream for a few days, and if Candida is confirmed or suspected, an imidazole cream. For confirmed bacterial balanitis, a seven-day course of oral flucloxacillin is necessary or, if allergic to penicillin, erythromycin or clarithromycin. Recurrent or chronic problems require specialist advice.

Balanitis in adults
Symptoms and causes of adult balanitis are similar to those of children. However, certain factors must be considered when deciding on investigations and management. Adult balanitis usually occurs in uncircumcised men who are unable to retract the f

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