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Balanitis - Management
Clinical features of underlying causes
- Non-specific dermatitis — redness of the glans penis, which often extends onto the skin of the shaft of the penis.
- Candidal balanitis — redness on the undersurface of the glans penis, with sparing around the urethral meatus. Small, eroded papules may be present with a white cheese-like matter, that can be rubbed off easily. In people with diabetes, candidal balanitis often presents with more severe features (such as intense redness of the glans penis and pain).
- Irritant or allergic contact dermatitis — redness of the glans penis with localized swelling (especially in allergic contact dermatitis).
- Gardnerella-associated balanitis — a fishy odour and a sub-preputial mucoid discharge (see the CKS topic on Bacterial vaginosis).
- Streptococcal infection — may present with a rapid onset of severe penile redness and pain, and is usually accompanied by a purulent exudate. Streptococcal balanitis with exudate can be distinguished clinically from urethritis with urethral discharge by the pattern of redness on the glans penis. In streptococcal infections there is usually no redness of the urethral meatus, unlike urethritis where the urethral meatus is typically red.
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