There is always white residue on the glans

Every man in life attaches great importance to his health, especially reproductive health, and pays attention to his genitals. Recently, Mr. Wang found white residue on his glans penis. After observing it for several days, he was very worried about his health problems. So what is the reason for the white residue on the glans penis? What kind of examinations do you need to do?

Balanitis is an inflammation of the glans penis caused by trauma, irritation or infection.

Causes

Balanitis is related to many factors, which can be divided into infectious factors and non-infectious factors. Under normal circumstances, a large number of bacteria, yeasts and spirochetes can parasitize in the foreskin sac, and when local or systemic resistance is weakened, these microorganisms can become pathogenic pathogens. Balanitis is mainly caused by bacteria, such as Escherichia coli, Staphylococcus, Streptococcus, followed by Candida, Trichomonas, Mycoplasma, Chlamydia, Gonorrhea, etc. can also cause balanitis.

Non-infectious factors include stimulation from urine, alkaline substances (such as detergents) and foreign substances (such as condoms); friction and trauma; excessive foreskin and insufficient cleaning leading to accumulation of smegma, which can cause damage to the glans foreskin mucosa and aggravate infection by various pathogens.

Clinical manifestations

1. Acute superficial galactitis

It is mainly seen in young and middle-aged people with active sexual life, and the infecting bacteria are usually the same as the strains of bacterial vaginosis of their sexual partners. At the beginning of the disease, the local skin is flushed, and the glans penis feels burning and itchy. In the acute stage, the foreskin is turned back to reveal edematous erythema, erosion, exudate and bleeding on the glans penis. In severe cases, blisters may appear. If secondary infection occurs, ulcers may form, covered with purulent exudate, and local pain and tenderness are obvious. Some patients may have mild systemic symptoms, such as fatigue and weakness. In the chronic stage, only the inner plate of the foreskin and the coronal sulcus have flaky flushing, or cracks like broken porcelain.

2. Annular ulcerative glansitis

It may be the early mucosal damage of Reites disease, or it may be related to the long-term stimulation of smegma. The clinical manifestation is erythema on the glans penis, which gradually expands and becomes ring-shaped or multi-ring-shaped, and may later form shallow ulcers. The main feature of this disease is one or more round lesions on the glans penis, with a red erosive surface in the middle and a white narrow band on the edge, forming a ring. If secondary infection occurs, the symptoms may be aggravated and lose their ring-shaped characteristics.

3. Candidal balanitis

Caused by Candida infection, most commonly Candida albicans. Clinical manifestations include erythema of the foreskin and glans penis, smooth surface, slight desquamation around, scattered papules or small pustules around, and slowly expanding to the surrounding area. In the acute stage, edema, erythema, erosion, and exudate may occur. In severe cases, it may affect the penis body, scrotum, inner thigh and groin. It is mostly caused by sexual contact infection, but it can also be secondary to diabetes, wasting diseases, and long-term and large-scale antibiotic or hormone treatment.

4. Cytoplasmic balanitis

It is more common in middle-aged patients. Generally, there are no obvious conscious symptoms. Persistent, localized, infiltrative, dark red-brown patches occur on the glans penis, with clear boundaries, smooth surface, many small red spots or erosions, easy bleeding, and no ulcers. Histopathology has diagnostic value, and is characterized by band-like inflammatory cell infiltration in the superficial dermis, mixed with a large number of plasma cells.

5. Amoebic balanitis

When the foreskin and glans become inflamed, the barrier function of the epithelium is lost, which makes it easy for amoeba infection. The clinical manifestations are infiltrated erythema, erosion, shallow ulceration, obvious tissue necrosis and pain.

6. Mica and keratomatous pseudoepitheliomatous glansitis

It is more common in patients over 50 years old, often accompanied by phimosis. The skin of the glans is infiltrated and hypertrophic, with local hyperkeratosis and mica-like crusts, which are silvery white. The glans loses its normal elasticity and gradually atrophies.

7. Trichomonas balanoposthitis

It is a mild, transient erosive glans inflammation caused by trichomonas infection. Patients often feel itchy, and the symptoms worsen during urination. Initially, erythema and papules appear on the glans, with clear boundaries and gradually expanding. There may be small blisters ranging from needle-sized to millet-sized on the erythema, which may expand and fuse with each other to form a mild erosive surface.

8. Dry obstructive glansitis

The early stage of the disease is chronic glans inflammation, with thickened mucosa, ivory white lesion area, and desquamation of the epidermis. In the late stage, the local area is scar-like atrophy. It can cause urethral stenosis and foreskin adhesion.

Diagnosis

It is mainly based on clinical manifestations, combined with etiology and pathological examination. For example, if it is caused by Candida infection, direct microscopic examination and culture of the lesion site can find Candida; if it is caused by amoeba, smear examination of secretions can find amoeba; pathological changes of plasmacytoid glansitis have diagnostic value. This disease should be distinguished from fixed drug eruption caused by drugs.