Balanitis

HISTORY:

Penile ‍rashitchingpainswelling for ‍ ‍hoursdays

‍rash

‍itching

‍pain

‍swelling

‍irritation

‍foul smell

‍difficulty retracting foreskin

‍dysuria

‍sores on the glans

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills

‍lymph node enlargement in the groin

Worsening factors: ‍none

Treatments tried: ‍none, ‍effectiveineffective



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Abdomen: ‍softsemi-softtense, ‍non-tender ‍, ‍non-distended, ‍

Genital: ‍normal, testicles ‍normal, penis ‍normal



ASSESSMENT:

‍Balanitis ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Swab for bacterial culture

- Swab for fungal culture

- STI screening

- Blood work: ‍Glucose, ‍HbA1C

- Patch testing

- ‍Topical antifungals

- ‍Topical steroids

- ‍Oral antifungals

- ‍Oral antibiotics

- ‍Analgesics

- Good hygiene practices

- Avoidance of irritants (soaps, lotions, latex condoms if allergic)

- Circumcision

- Referral to dermatologist

- Referral to urologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms do not improve or worsen, or if new symptoms such as discharge or ulceration develop