Red spots on the glans

The glans is a very important organ for men and is prone to problems. The most typical phenomenon is the appearance of red spots on the glans. Regardless of whether there is itching or pain, this symptom is very likely to be glansitis. We can make a judgment based on the condition of glansitis and compare it with the characteristics of our own body. If it is glansitis, it must be treated in time to avoid further harm.

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.

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.

1. General treatment

(1) Keep the area clean, avoid various irritations, and clean the glans penis and foreskin daily.

(2) Avoid unprotected sexual intercourse and suspend sexual activity during treatment. If it is trichomonas or candidal glansitis, both husband and wife should be treated at the same time.

(3) Avoid using corticosteroids during the acute phase to avoid aggravating the infection. If the foreskin is severely edematous, do not forcibly retract the foreskin.

(4) If there are ulcers or erosions on the inner foreskin and glans penis, the dressing should be changed promptly, twice a day.

(5) Eat less spicy food and avoid smoking and drinking.

2. Local treatment

For patients with erosive exudation or purulent secretions, apply wet compresses with 1% ethacridine solution or 1:8000 potassium permanganate solution. For patients with dryness and scaling, apply glucocorticoid ointment. For patients with Candida infection, clean the affected area with sodium bicarbonate solution and then apply imidazole ointment. For patients with Trichomonas infection, rinse with 0.5%-1% lactic acid solution or 0.5% acetic acid solution, and then apply anti-inflammatory ointment. Intermittent administration of medium-acting fluoride-free hormone ointment has a good effect on synovial glansitis.

3. Systemic medication

Systemic antibiotics should be selected according to the pathogen and drug sensitivity test. For the treatment of acute superficial balanitis and annular erosive balanitis, antibiotics sensitive to Gram-positive cocci can be used first. The treatment of trichomonal balanitis should start with metronidazole. Fluconazole or itraconazole is often used to treat balanitis caused by Candida albicans.

4.Surgery

Patients with recurrent balanitis due to excessive foreskin or phimosis should undergo circumcision after the inflammation subsides.