Inflammatory Lesions

Balanitis circumscripta plasmacellularis ( Zoon's balantitis): occurs in uncircumcised men with an unknown aetiology (possibly autoimmune). It consists grossly of well-defined brown/red plaques, solitary or multiple, and clinically resembles erythroplasia of Queyrat.

Balanitis xerotica obliterans (BXO): this is the male equivalent of lichen sclerosus et atroph-icus of vulva. It may cause narrowing of the urethral meatus or phimosis. There is a weak association with carcinoma of the foreskin. The gross appearances are that of grey-white foci of atrophy in the foreskin or perimeatal glans.

Balanoposthitis: infection of the glans and foreskin, usually due to candida, anaerobes, gardnerella or pyogenic bacteria. It is common in uncircumcised newborns or uncircumcised men with poor hygiene and accumulation of smegma and due to the propensity of pathogenic bacteria to adhere to the mucosal surface of foreskin. It causes phimosis.

Fournier's gangrene: necrotizing fasciitis of the genitalia due to bacterial infection. Risk factors include trauma, burns, anorectal disease, diabetes, leukaemia and alcoholic cirrhosis.

Sexually transmitted disease: these include granuloma inguinale (calymmatobacterium granu-lomatis), herpes simplex virus, lymphogranuloma venereum (chlamydia trachomatis), candida, molluscum contagiosum, scabies and syphilis.

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