How to treat sicca obstructive glans?

Balanitis is a common inflammatory disease in men. Men with prepuce that is too long are at high risk of developing balanitis. Clinically, there are several types of balanitis, one of which is called sicca occlusive balanitis. Once you have this type of balanitis, the patient's glans will become itchy and will atrophy to varying degrees. The glans is also prone to flaking due to dryness. So what is the correct treatment for this type of balanitis?

How to treat sicca obstructive glans?

The main purpose of treatment is to relieve symptoms, reduce discomfort and prevent deterioration. External application of corticosteroid ointment or intradermal injection can relieve local symptoms. Foreskin stenosis can be treated with phimosis. Foreskin stenosis can be treated with urethral dilation.

Prognosis:

The disease is unlikely to worsen under proper treatment. Studies have shown that the overall malignancy rate is 5%, but the malignant disease progresses rapidly. Therefore, early-stage patients need to be followed up once a month for a total of 3 months. If there are persistent ulcers or new ulcers, they need to see a doctor immediately.

Differential diagnosis:

1. Psoriasis of the glans penis

Most patients have psoriasis lesions elsewhere on the body, which may also occur on the glans penis and the inner surface of the foreskin, manifesting as smooth, dry erythema with clear borders, and scales can be seen when scraped.

2. Mica and keratotic pseudoepitheliomatous glansitis

Isolated, well-defined infiltrated hypertrophic lesions or hyperkeratotic plaques with mica-like silvery-white scales can be seen on the glans penis. The glans penis shrinks and loses its normal elasticity, and there are generally no subjective symptoms.

Check:

1. Physical examination

Most of the skin lesions are located on the inner side of the foreskin, glans, urethral opening, coronal sulcus, and occasionally the penis. In the early stage of the disease, it is chronic glansitis, with infiltrated and hypertrophic skin, brown-red color, desquamation on the surface, and sometimes hemorrhagic blisters. Later, tooth-colored white spots appear on the glans and urethral opening, and the tissues in the lesion site atrophy and fibrosis, losing the normal spongy feeling.

2. Histopathological examination

The epidermis is hyperkeratotic, the spinous cell layer is atrophied, and the basal cells are liquefied and degenerated; the collagen fibers in the superficial dermis are obviously edematous and homogenized, the elastic fibers disappear, and there is infiltration of band-like lymphoid tissue cells below the edematous area. After the course of the disease becomes chronic, the epidermis can be seen to atrophy, while the inflammation and edema are reduced, and the papillary dermis becomes denser and more homogenized. When basal cell vacuolation and edema of the papillary dermis are severe, blisters may appear at the junction of the epidermis and dermis.