Last Updated: 2021-10-15
Soorbalanitis, Balanitis candidamycetica, Balanoposthitis candidamycetica.
Fungal infection of the glans penis and foreskin caused by Candida spp.
- Pathogen: Candida spp. (mostly Candida albicans, C. glabrata also occurs)
- An infection with Candida occurs, for example, during sexual intercourse - especially women often have Candida colonisation in the vagina
- Predisposing factors
- Topical therapy with external steroids or antibiotic ointments.
- Hygiene (missing or exaggerated)
- Lichen sclerosus et atrophicans
- Diabetes mellitus
- Initial itching
- Erythematous, pruritic, slightly scaly, weeping maculae
- The erythema then becomes flat and shiny, rich reddish-damp
- Blisters and erosions can also occur
- Similar to thrush stomatitis, there may be white spots which form irregular whitish deposits after some time
- With otherwise adequate hygiene, however, a minimal variant is more likely to be seen, i.e. only redness, but the whitish fungal material is washed or cleaned away
- Medical history (predisposing factors)
- Clinical features
- Myco. smear.
- Stool test for Candida.
- Glans penis
- Shank left out
In the course of the disease inflammatory swelling of the inner preputial sheet can occur up to the inflammatory phimos and increased purulent secretion due to secondary bacterial infection.
- Partner treatment (also for asymptomatic partners)!
- If a predisposing underlying disease exists, it should be addressed therapeutically.
- Adequate hygiene!
- Underpants and towels should be changed daily and washed with maximum heat.
- Use olive oil for cleaning, do not use soaps.
- Question about previous (possibly inadequate) antibiotic therapy with reduction of the physiological flora
- Disinfecting swiveling baths, e.g. polyvidon iodine (dilute in warm water until it looks like a "bad coffee", swiveling for 10min)
- Baths with mild tanning agents are also useful.
- Can only be treated well with local therapy.
- For severe inflammation combines steroids and antimycotic
- Antimycotic therapy with
- Clotrimazole cream 1% (Attention: Hexamidine can be irritating)
- Econazole Cream Cream 1%
- Ciclopirox cream Cream or Lsg.
- Ketoconazole cream cream 2%
- Amorolfin cream 0.25% cream
- For severe infestation: Fluconazole 150mg 1xtgl. p. o.
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- Stary A, Soeltz-Szoets J, Ziegler C, Kinghorn GR, Roy RB. Comparison of the efficacy and safety of oral fluconazole and topical clotrimazole in patients with candida balanitis. Genitourin Med 1996;72:98-102.
- Waugh MA, Evans EG, Nayyar KC, Fong R. Clotrimazole (Canesten) in the treatment of candidal balanitis in men. With incidental observations on diabetic candidal balanoposthitis. Br J Vener Dis 1978;54:184-6.
- Verma SB, Wollina U. Looking through the cracks of diabetic candidal balanoposthitis! Int J Gen Med 2011;4:511-3.
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- Braun-Falco`s Dermatologie Venerologie und Allergologie, 6. Auflage
- Edwards et. al. 2013 European guideline for the management of balanoposthitis. Int J STD AIDS. 2014 Aug;25(9):615-26.