Glansitis is an inflammation of the inner plate of the foreskin and the head of the penis. A lipid-like substance secreted in the normal foreskin cavity can accumulate into foreskin scale when the foreskin is too long or circumcised to irritate the foreskin and the head of the penis causing glans vulgaris. This disease can also be caused by bacterial or fungal infections or drug allergies.
Causes
The causes of this disease can be divided into two categories.
1. Simple or non-infectious factors
In addition to physiological prepuce, foreskin, after sexual maturity foreskin scale stimulation or a few mechanical injury factors and inflammatory changes in the glans.
2, infectious or infectious diseases
The glans penis caused by pathogenic microorganisms as the dominant factor, of which bacterial and fungal infections are the most common.
Clinical manifestations
The foreskin glans caused by drug allergy is a delayed type of metaplasia, which is quite common clinically and usually develops 24 to 72 hours after the drug is used.
If the navicular fossa is involved, there may be frequent and painful urination. Local burning sensation and itching may occur. Occasionally, fulminant edematous glans penisitis can occur, mainly manifesting as marked edema of the penile foreskin, severe itching, and shallow ulcers.
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1. Acute superficial glansitis
Mostly caused by underwear friction, trauma or soap, detergent local stimulation. The performance of edema, erythema, exudation, erosion, secondary infection with purulent discharge, easy to form ulcers, self-conscious pain.
2. Circumferential erosive glansitis
The glans and foreskin inflammatory damage is annular, or annular with cheese-like foreskin scale, easily broken into shallow ulcers over time, if the loss of annular features is not easily distinguished from superficial glansitis. This disease can exist alone or as a mucosal symptom of Reiter syndrome.
3. Plasmacytoid glansitis
It is a single or multiple chronic inflammatory disease that does not recede in middle age. The damage is plaque-like, with a smooth or desquamated or moist surface and a more pronounced infiltration. The boundary is clear and not easy to break, the surface can be seen like chili powder-like fine spots. The shape is difficult to distinguish from the glans proliferative erythema. If similar damage occurs in the female genitalia, it is called plasmacytoid vulvovaginitis.
4. Mica-like and keratotic pseudoepitheliomatous glansitis
The glans damage is infiltrated and thickened, hyperkeratotic and with mica-like scabs, and the affected area loses its normal elasticity and atrophies over time.
Examination
1. Candida glansitis (circumcision)
It can be found in the lesion of the glans, foreskin microscopic examination or culture of Candida.
2. Trichomonas glansitis
Trichomonas can be found on the secretion.
Differential diagnosis
1.Hard chancre
A hard ulcer with neat edges.
2. Gonorrhea
It can also occur as glans vulgaris, but mainly manifests as acute purulent urethritis.
3. Fixed erythematous drug rash
It is often caused by oral sulfonamides or painkillers and occurs on the pubic area, with redness and swelling, often breaking down and erosion, and also recurrence.
4.Other
Such as contact dermatitis, herpes zoster, and impetigo.
Complications
Secondary prepuce, external urethral stricture, anterior urethral stricture.
Treatment
1. Keep local cleanliness and prevent secondary infection. Local application of iodine and fluorine solution or anti-inflammatory ointment can be used. Allergic glans penis must be oral anti-allergy drugs and topical cortisone ointment.
2, exudate erosion can be used 3% boric acid water or 0.1% ralph lauren wet compress.
3, non-infectious subacute stage of the person available corticosteroid cream.
4, chronic phase or dry flaking available tetracycline cortisone ointment.
5, the infection is obvious, fever and lymph node enlargement, systemic application of antibiotics, such as cefadroxil or fluazinic acid, etc.
6, circumcision: if due to foreskin or foreskin edema can not be turned dip wash, poor drainage, by general treatment of inflammation still can not subside, feasible foreskin back incision, in order to facilitate drainage. After the inflammation has completely subsided, circumcision will be performed again.
Prevention
Wash the foreskin and penis head frequently to keep the foreskin cavity clean and dry. If the disease is found, the foreskin will be turned over in the affected area and cleaned with potassium permanganate solution, and antibiotics will be applied appropriately, which will be cured within a few days; if it is more serious, effective treatment will be required under the guidance of a doctor.