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Penile Leukoplakia

Balanitis Xerotica Obliterans


Presentation

  • Three patients presented with retention of urine, four had difficulty in passing urine and two patients presented with painful erection.[ajol.info]
  • The clinical presentation and complications of lichen sclerosus are well known. What is less well known is the true incidence of the condition.[ncbi.nlm.nih.gov]
  • Features a downloadable Online Image Collection that you can use to enhance your presentations. Presents two brand-new chapters covering urinary cytology and fine needle aspiration to keep you up to date.[books.google.es]
  • Find information quickly and easily with a format that includes clearly presented algorithms, tables, and figures. Effectively review for the boards using the self-assessment questions at the end of each chapter.[books.google.com]
  • Furthermore, on histological examination BXO presents a very characteristic picture. Hyperkeratosis is present and the epidermis is atrophic with thinning of the rete pegs. Vacuolar degeneration of the basal layer may be present.[cirp.org]
Easy Bruising
  • The white thin fragile areas, sometimes surrounding the foreskin in a figure of eight pattern, have a crinkly surface; their fragility may lead to easy bruising and erosions. Later on, the foreskin opening can shrink, leading to pain on intercourse.[londoncircumcisioncentre.co.uk]
Follicular Plugging
  • The presence of dells and of follicular plugging is regarded as an important diagnostic aid.[cirp.org]
Penile Lesion
  • Treatment of Penile lesion T1 G3, T 2 Partial / total amputation. Conservative strategy is an alternative in very carefully selected patients. 22. Treatment of Penile lesion Local recurrence Second conservative procedure. Partial / total amputation.[slideshare.net]
  • The management of benign penile lesions usually involves observation or topical corticosteroids; however, neoplastic lesions generally require surgery.[aafp.org]
  • However, only 50% of these patients will have cancer in the lymph nodes as these lymph nodes are often "reactive" to inflammation or super-infection in the penile lesion.[bradyurology.blogspot.com]
  • Invasive tumours require staging of the primary penile lesion and inguinal and pelvic lymph nodes. Local staging can be performed using magnetic resonance imaging (MRI).[patient.info]
Incontinence
  • Focus on today's hot topics in urology , including stress and mixed urinary incontinence; prolapse therapy; therapy for overactive bladder; and targeted therapy for renal cell carcinoma.[books.google.com]
  • Brandes Springer Science & Business Media , 10 oct. 2008 - 379 páginas 0 Reseñas Urethral injury may be of secondary importance when the patient comes into the emergency room, but devastating urological complications, such as sexual dysfunction, incontinence[books.google.es]
  • Pigment incontinence is usually present. Diagnosis confirmation The key differential diagnosis is lichen planus, which may present with reticulated white lesions on an erythematous background, erosions, ulcerations or polygonal papules.[dermatologyadvisor.com]

Workup

  • Imaging Metastatic workup should include CXR, bone scan, and CT scan of the abdomen and pelvis. Disseminated disease is present in less than 10% of patients at presentation.[health.am]

Treatment

  • Treatment Options Potent topical corticosteroids are the mainstay of treatment. In general, the risk of atrophy from uncontrolled disease outweighs the risk of pulse therapy with potent topical corticosteroids.[dermatologyadvisor.com]
  • Further treatment, or treatment of circumcised patients, is more challenging. Intraurethral steroids provide efficacious therapy for stricture disease in patients with biopsy proven BXO before invasive surgery. 4.[londoncircumcisioncentre.co.uk]
  • The treatment of balanitis xerotica obliterans I. Depasquale 1 , A.J. Park 1 and A.[cirp.org]
  • Unfortunately there is no definitive treatment for the condition. BXO requires specialist assessment and treatment and might require joint management from a urologist and dermatologist.[irishhealth.com]
  • No consensus exists about the optimal approach to treatment for balanitis xerotica obliterans. Surgery (including skin grafting), a variety of pharmacologic therapies, and laser treatment have been used with varying degrees of success.[medpagetoday.com]

Prognosis

  • Submission of the foreskin for histological analysis should always be considered, as prognosis differs for lichen sclerosus vs nonlichen sclerosus histology. We recommend a care pathway for boys with lichen sclerosus.[f1000.com]
  • The prognosis depends upon several factors and may be guarded Who gets Balanitis Xerotica Obliterans? (Age and Sex Distribution) Balanitis Xerotica Obliterans is a condition of the penis that usually affects men in the 30-50 years age group.[dovemed.com]
  • References: [7] [8] Prognosis[amboss.com]
  • Prognosis The prognosis for urachal cancer remains poor with its insidious course and advanced disease at presentation.[abdominalkey.com]
  • Physical examination is of paramount importance as staging (depth of spread; see below) is most important in determining prognosis.[bradyurology.blogspot.com]

Etiology

  • There appears to be an increased risk for family members to develop LS, suggesting a genetic component to the etiology. General Prevention Neonatal circumcision appears to be protective.[unboundmedicine.com]
  • Operations on the genitals, such as circumcision and dorsal incision, are not etiologic factors in our opinion. In contradistinction to Stühmer's 2 belief that the disease occurs only in young adults, we feel that it may occur at any age.[jamanetwork.com]
  • Etiology: may be idiopathic or may be associated with an underlying carcinoma. Treatment: variable response to laser, circumcision, steroids, antifungals, and retinoids (in other words, the verdict is still out on an appropriate therapy).[auanet.org]
  • Abstract Background: Balanitis Xerotic obliterans (BXO) or Penile Lichen Sclerosus is a dermatological condition affecting the genitalia and associated with chronic, progressive, sclerosing inflammatory dermatosis of unclear etiology.[ajol.info]
  • While the exact etiology is unclear, BXO is more common in some conditions such as hypospadias and secondary phimosis. The reported rates of BXO in children ranges from 9 - 40%.[spuonline.org]

Epidemiology

  • Balanitis xerotica obliterans: epidemiologic distribution in an equal access health care system. South Med J . 2003 Jan. 96(1):9-11. [Medline] . Huntley JS, Bourne MC, Munro FD, Wilson-Storey D.[emedicine.medscape.com]
  • Epidemiology The prevalence is 1 in 300 to 1 in 1,000 men. Peak incidence appears to be 21 to 30 years of age ( 2 ). Neonatal circumcision appears to prevent development of BXO.[unboundmedicine.com]
  • 16060864 ) Kiss A....Merksz M. 2005 39 Heroic measures may not always be justified in extensive urethral stricture due to lichen sclerosus (balanitis xerotica obliterans). ( 15351594 ) Peterson A.C....Webster G.D. 2004 40 Balanitis xerotica obliterans: epidemiologic[malacards.org]
  • Epidemiology Rare type of malignancy in industrialized countries More common in developing countries in Africa, South America, and Asia Peak incidence : 60 years of age References: [1] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology Balanitis is more common in men than in boys. It is present in approximately 11% of attendees at genitourinary medicine (GUM) clinics. Balanitis affected 5.9% of uncircumcised boys in one study and 14% in another. Risk factors.[unityskinclinic.com]
Sex distribution
Age distribution

Pathophysiology

  • However, circumcision later in childhood may not be protective; affects foreskin and glans in 57–100%, meatus in 4–37% with involvement of urethra in about 20% Etiology and Pathophysiology The exact cause of BXO is unknown.[unboundmedicine.com]
  • Etiology Pathophysiology Although the pathogenesis is unknown, HLA-subtype susceptibility and high rates of associated autoimmune disorders suggest that the disorder may be autoimmune in nature.[dermatologyadvisor.com]
  • AIDS Pathophysiology AIDS Transmission AIDS Treatment AIDS Prognosis History of AIDS AIDS Stigma[news-medical.net]
  • Pathophysiology The etiology of male genital lichen sclerosus is unknown, but it is thought to be multifactorial. Balanitis xerotica obliterans (BXO) has occurred in monozygotic twins, which suggests a genetic basis for the disease in some cases.[emedicine.medscape.com]
  • Preetika Lakhera BHMS For well formatted and illustrated article, please see attached file- Balanitis and Homoeopathy.pdf Contents Definition. 2 Etymology. 2 Anatomy. 2 Glans. 2 Corpus cavernosum.. 3 Corpus spongiosum.. 3 Urethra. 3 Predisposing factors. 3 Pathophysiology[homeopathyworldcommunity.ning.com]

Prevention

  • General Prevention Neonatal circumcision appears to be protective. Early diagnosis may allow for earlier treatment to prevent anatomic changes, such as stricture, and prevent malignant change ( 1 ).[unboundmedicine.com]
  • The following factors may be considered towards the preventative steps for Balanitis Xerotica Obliterans: Prevent phimosis by treating any infections early and in a timely fashion Refraining from intense sexual activities or ensuring care during sexual[dovemed.com]
  • Treatment is aimed at the relief of symptoms and prevention of disease progression. Topical steroid therapy is the first-line ther...[5minuteconsult.com]
  • A hard, white ring of tissue often forms on the glans which prevents the foreskin from retracting.[medic8.com]
  • Awareness of the diagnosis and its typical features will enable the patient to receive the correct treatment and prevent further distressing management cul-de-sacs – such as referral to rule out sexually transmitted infection.[pulsetoday.co.uk]

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