Balanitis is soreness and inflammation of the penis glans (head) in uncircumcised males. In circumcision, the foreskin is removed from the head of the penis to protect it from certain kinds of infection. Balanitis is usually caused by yeast, however, it can also be bacterial or viral. It is not infectious.
ZB (Zoon Balanitis) is characterized by a non venereal disorder that primarily affects uncircumcised middle-aged to elderly males. It is clinically presented as a solitary, glossy, well-defined erythematous plaque on the glans. ZB is also known as Zoon’s plasma cell balanitis or circumscripta plasmacellularis. Textbooks and literature classify it as rare, yet it is most likely underdiagnosed.
This disease primarily affects the males who are uncircumcised
because yeast and bacteria thrive in the damp, warm environment behind the foreskin. The men who are most affected by Zoon’s Balanitis have the following characteristics:
- Have diabetes, as excess sugar (sugar) on the skin promotes bacterial and fungal growth.
- Are overweight.
- Have sexually transmitted infections.
- Possess an allergy to chemicals that irritate.
- Follow poor hygiene.
- Are in their forties or fifties.
Zoon’s Balanitis Symptoms
It is normally asymptomatic, with the patient only presenting with a change in genitalia appearance. Occasionally, it is accompanied by symptoms including pruritus, dysuria, discomfort, and a burning feeling.
Some other symptoms are:
- Pain while urinating.
- Foul scent.
- The appearance of lesions or sores on the glans.
- Smegma under the foreskin.
- Pain and discomfort on the glans.
- Redness or red spots on the penis.
- Skin patches on the penis that are glossy or white.
- Itching in the area of the foreskin.
- Dyspareunia or discharge with bloodstains.
If the person is not circumcised, the danger of Balanitis increases. To confirm the diagnosis of Zoon’s balanitis, which is an asymptomatic lesion, a histological investigation of the tissue that is affected is required.
Zoon’s Balanitis Causes
The most common cause of this asymptomatic illness is poor hygiene. The following are some other causes:
- Scabies infection.
- Reactive Arthritis.
- Itchy, dry, scaly skin.
- Sexual yeast infection (candidiasis).
Zoon’s Balanitis Cancer
Zoon’s balanitis is a harmless disease that is marked by a single, shiny, red-orange plaque on the glans and/or prepuce that lasts for a long time and does not hurt. In rare cases of Zoon’s disease, the chronic inflammatory sores in the penile area turned into squamous cell carcinoma.
Early lesions exhibit a thicker parakeratotic epithelium on a histological level. Cellular inflammation in the upper dermis includes numerous plasma and lympho-histiocytic lymphocytes as well as dilated capillaries that allow extravasation of red blood cells as well as hemosiderin deposition. The lesions have a larger percentage of IgG4-positive plasma cells, but there is no evidence of cicatrization.
Zoon’s Balanitis Treatment
Good cleanliness, emollient lotions, and topical corticosteroids are a part of the first management plan. Circumcision is almost always beneficial. Tacrolimus is an alternate treatment that can be used on patients who have a compelling reason to avoid using topical corticosteroids, as well as on patients who choose not to undergo surgery.
The treatment options depend upon the causes of the disease. These are as follows:
- Improved health and Sanitation: To prevent the chance of balanitis recurrence, the physician advises washing and drying under the foreskin frequently.
- Antifungal ointments: Antifungal cream such as clotrimazole is often used to treat Balanitis.
- Antibiotics: If the symptoms are caused by a sexually transmitted disease, the provider recommends antibiotics to treat the infection.
- Management of diabetes: The management of diabetes helps in treating Zoon’s Balanitis.
- Circumcision: If the patient has recurring symptoms of Balanitis, a surgical procedure such as circumcision is preferred for the treatment.
- This disease can be prevented from occurring by bathing frequently to avoid developing balanitis.
- Spending some time pulling the foreskin back and cleaning the area underneath it is also effective for prevention.
- It is also suggested to always use a condom when engaging in sexual activity to avoid the development of the disease.
- Several other treatment options for this noncancerous illness are identified, including photodynamic therapy (PDT), radiation, and topical medicine.
Some of the other management techniques are as follows:
- Copper vapor laser.
- Carbon dioxide laser.
- Fusidic acid.
- Tannic acid.
Balanitis usually improves with treatment. Balanitis frequently recurs after treatment in males who are not circumcised. Men are more likely to contract HIV if they do not maintain proper personal hygiene, such as washing under their foreskins. Thus, proper preventive measures are required ta avoid this disease.