A CLINICO-ETIOLOGICAL STUDY ON BALANOPOSTHITIS

Background: Balanoposthitis is a relatively common condition affecting both pediatric patients and adults. In adults, uncircumcised males with diabetes mellitus are at the highest risk, with higher prevalence. Although majority of patients will respond to changes in hygiene and empiric therapy, about one in ten will show recurrence needing further evaluation and more targeted management. Aims And Objectives: To study the clinical features in patients of Balanoposthitis, and to determine the etiological agents by microbiological spectrum and the risk factors associated with it. Materials And Methods: The present hospital based cross-sectional study was conducted for a period of 18 months on 75 patients with clinically diagnosed balanoposthitis visiting outpatient and inpatient under the Department of Dermatology, Venerology and Leprosy of Basaveshwar teaching and general hospital attached to Mahadevappa Rampure Medical College, Kalaburagi. A pre-designed semi-structured proforma, which was internally validated was used to collect the necessary information on all the needed variables. Demographic details were recorded and a detailed history of symptoms, history of external application, and history of systemic illness was obtained. The systemic and genital examination was done. Subpreputial discharge was collected on swabs and sent for KOH mount, bacterial and fungal culture. Results: In the present study, the mean age was estimated to be 44.60 ± 10.49 years. Majority were married (90.7%), had completed just high school education (90.7%). On enquiring whether any topical agents were applied in the past, only 10.7% had agreed to it. Subpreputial discharge was found to be the most common clinical feature (72.0%), followed by erythema (54.7%). The involvement of preputial skin was observed in about 44.0% cases. Herpes genitalis was evident in 5.3% cases, while syphilis was present in only 1 individual, and 3 other subjects were positive for HIV infection. The only complication was non-retractable prepuce, which was appreciated in about 9.3% cases. About 74.1% of the subjects showed positive for KOH Mount. However, among them, only 35 individuals were found to be positive on fungal culture. Staphylococcus aureus was the most common bacteria (25.9%), followed by staphylococcus epidermis (22.2%). Diabetes mellitus was regarded as commonly associated risk factor (74.7%). The commonest infectious etiology was observed to be bacterial infection (73.3%), followed by fungal infection (46.7%). The commonest non-infectious etiologies were observed to be adverse drug reaction and irritant contact. Conclusion: Subpreputial discharge was found to be the most common clinical feature followed by erythema, fissures over preputial skin and ulcer. Bacterial and fungal infection were common infectious etiologies while adverse drug reaction and irritant contact were non-infectious etiologies causing Balanoposthitis. Co-morbidities such as diabetes mellitus and hypertension were regarded as the risk factors associated with Balanoposthitis.