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Differenzialdiagnose und Management der Balanitis

Differential diagnosis and management of balanitis

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Zusammenfassung

Balanitiden stellen eine heterogene Gruppe infektiös oder primär entzündlich bedingter Dermatosen dar, die von malignen Veränderungen abgegrenzt werden müssen. Neben Hefepilzen und bakteriellen, auch anaeroben Erregern kommen seltener auch Viren und Parasiten als Auslöser der infektiösen Balanitis infrage. Urethritiserreger können direkt oder sekundär irritativ durch den Fluor zu einer Begleitbalanitis führen. Lichen ruber, Psoriasis und Kontaktekzeme können typischerweise zur Entzündung an der Glans führen. Neben einem Ganzkörperstatus ist deshalb auf eine genaue Anamnese im Hinblick auf Kontaktnoxen und Sexualverhalten zu achten. Infektionen müssen behandelt und der Präputialraum muss nach Möglichkeit trocken gelegt werden. Dabei ist auf eine ausgewogene Hygiene zu achten. Als Ultima Ratio bei den meisten Formen der chronischen Balanitis kommt die therapeutische Zirkumzision infrage.

Abstract

Balanitis is a descriptive diagnosis for a heterogeneous group of infectious or inflammatory dermatoses which have to be differentiated from malignant conditions. Balanitis is caused not only by Candida spp. and bacterial infections, including anaerobic bacteria: viral infections, parasites and other sexually transmitted infections (STI) also have to be considered. Lichen planus, psoriasis and contact dermatitis can characteristically lead to inflammatory conditions of the glans penis. In addition to a complete skin examination, a thorough patient history with respect to topically applied products and sexual behavior is essential. Infections must be treated and the glans penis should be kept dry. It is important to ensure a balanced genital hygiene in patients. As a last resort therapeutic circumcision can be considered for most forms of chronic balanitis.

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Authors and Affiliations

  1. Dermatologisches Ambulatorium, Stadtspital Triemli Zürich, Herman-Greulich-Str. 70, 8004, Zürich, Schweiz

    S. Borelli & S. Lautenschlager

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  1. S. Borelli
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  2. S. Lautenschlager
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Correspondence to S. Borelli.

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S. Borelli und S. Lautenschlager geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Borelli, S., Lautenschlager, S. Differenzialdiagnose und Management der Balanitis. Hautarzt 66, 6–11 (2015). https://doi.org/10.1007/s00105-014-3554-0

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