Granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin instillation therapy

We report a rare case of granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin (BCG) instillation therapy in a 58-year-old man, which followed transurethral resection (TUR) for recurrent bladder cancer, when his anterior urethra was slightly narrow and his foreskin was with phimosis. Intravesical BCG instillation therapy was started for prophylaxis of recurrent bladder cancer after TUR. Multiple painless firm papules on glans penis, edema in the foreskin and low-grade fever appeared after the seventh instillation, for which the single antituberculous agent isoniazid (300 mg/day) was administered. Biopsy of the papules on glans penis and foreskin revealed granulomatous balanoposthitis. Low-grade fever normalized and the papules disappeared within 1 week. The patient continued chemotherapy with isoniazid for the next 12 months. There was no recurrence of bladder cancer or balanoposthitis for 15 months and to date.     

氟康唑治疗念珠菌性龟头包皮炎53例疗效观察

目的　探讨氟康唑对念珠菌性龟头包皮炎的临床疗效。方法　将 98例患者随机分为两组 ,治疗组 ( 5 3例 )口服氟康唑 15 0mg ,qd× 5d ,用药期间停用其它的口服药及外用真菌药 ;对照组 ( 4 5例 )用霉克霜外搽患处 ,bid ,连用 2W ,用药期间停用口服药。结果　治疗组痊愈率为 90 .5 7% ,总有效率为 98.11% ;对照组痊愈率为 2 .2 2 % ,总有效率为 66.67% ,治疗组均显著高于对照组 (P均 <0 .0 1)。结论　氟康唑治疗念珠菌性龟头包皮炎疗效满意     

Diagnosis of a preputial cavity abscess with bedside ultrasound in the emergency department

Bedside ultrasound has become an important diagnostic tool for emergency physicians. Clinical investigators have demonstrated that evaluating soft tissue infections with ultrasound is useful for the detection of subcutaneous abscesses. Bedside ultrasound of a preputial cavity abscess in the Emergency Department has not been previously described in the English medical literature. A preputial cavity abscess, a rare complication of balanoposthitis, is a collection of pus between the foreskin and the distal penis. This case report describes the use of ultrasound to diagnose a penile abscess and reviews the related literature.     

包皮环切术联合氟康唑治疗复发性念珠菌性龟头包皮炎疗效观察

目的观察包皮环切术联合氟康唑治疗复发性念珠菌性龟头包皮炎疗效。方法将入选的80例患者按就诊顺序随机分成手术治疗组和非手术治疗组,手术治疗组予氟康唑150mg单剂1次口服,局部外用生理盐水冲洗皮损2～3次/d,每次冲洗后外搽1%～2%龙胆紫液,约1周时待临床症状消失后行包皮环切术,非手术治疗组治疗同手术治疗组手术前的治疗方法,疗程2周,疗程结束后观察两组患者的疗效。结果手术治疗组和非手术治疗组治疗3周时治愈率比较,差异无统计学意义(P0.05),治疗后6个月时复发率比较,差异有统计学意义(P0.05)。结论包皮环切术联合氟康唑治疗复发性念珠菌性龟头包皮炎疗效确切,复发率显著下降,值得临床推广。     

从包皮龟头炎患者皮损处分离鉴定马拉色菌

目的：了解马拉色菌属各菌种在包皮龟头炎皮损处的构成及其在发病中的作用。方法：从患处取材直接镜检查见马拉色菌孢子和(或)菌丝的包皮龟头炎患者作为研究对象。用胶带法取材后分别接种在含菜子油的培养基及无放线菌酮的沙堡培养基分离菌种。依据生理生化和形念学特点及转种到科玛嘉显色培养基和米粉吐温80琼脂培养结果鉴定出马拉色菌和(或)念珠菌。结果：81例患者中有57例(70．37％)培养并鉴定出马拉色菌(共60株)，其中糠秕马拉色菌20株(33．33％），合轴马拉色菌18株(30．00％)，钝形马拉色菌17株(28．33％)，球形马拉色菌5株(8．33％)。有37例同时分离到念珠菌(其中72．97％为白念珠菌）。44例仅检出马拉色菌的患者中有23例接受抗真菌治疗。结论：糠秕马拉色菌、合轴马拉色菌、钝形马拉色菌是包皮龟头炎患者皮损处的主要菌种；马拉色菌可能单独或与念珠菌协同引起包皮龟头炎。     

Ablative erbium:YAG laser treatment of idiopathic chronic inflammatory non-cicatricial balanoposthitis (Zoon's disease) – A series of 20 patients with long-term outcome

Abstract

Background: Chronic inflammatory non-cicatricial balanitis/balanoposthitis (Zoon 1952) is not uncommon among aged uncircumcised males. The course is chronic and will lead to severe epidermal atrophy. This disease is poorly responsive to topical treatment. The golden standard for treatment is circumcision. Objective: This study was performed to evaluate the efficacy and safety of ablative erbium:YAG laser treatment. Methods: An uncontrolled trial was performed with 20 Caucasian male patients (mean age 64.8 years) who presented with chronic inflammatory non-cicatricial balanitis or balanoposthitis. The patients received multiple topical treatments. The disease duration ranged from 1 to more than 7 years. Diagnosis was confirmed by histology. Topical anaesthesia was performed before erbium:YAG laser ablation (focus 1.6–5 mm; frequency 8 Hz; impulse energy mostly 800 mJ; fluence between 11.3 and 20 J cm^?2). The pulses were partly overlapping. The pain sensation was recorded by visual analogue scale (VAS). Complete clearance was defined as complete absence of erythematous, smooth-faced, ‘wet’-looking patches or erosions. Patients were requested to attend a regular follow-up once a year. The outcome was further assessed by patient's global assessment (PGA). Results: In all patients a complete re-epithelialization could be achieved within 2–3 weeks. During follow-up between 3 months and 30 months (mean 12.1 ± 7.2 months), a complete and stable clearing was achieved in 20 patients (100%). There were no severe adverse effects. With topical anaesthetic cream the VAS was very low (mean 1.5 ± 4.1 mm for 18 patients and 22 treatments). All but three patients were ‘completely satisfied’ with the procedure and the outcome; three were ‘satisfied’. Conclusions: Ablative erbium:YAG laser therapy is a safe, effective and minimally invasive treatment option in chronic inflammatory non-cicatricial balanitis/balanoposthitis.     

克痒舒洗剂治疗念珠菌性龟头包皮炎的疗效观察

目的观察克痒舒洗剂治疗念珠菌性龟头包皮炎的疗效.方法选择100例念珠菌性龟头包皮炎患者随机分为两组,治疗组用克痒舒洗释液外洗龟头,一日两次.同时用洁肤净洗释液作为对照.结果克痒舒治疗组疗效明显优于对照组,并有统计学意义.结论克痒舒洗剂外洗治疗念珠菌性龟头包皮炎不失为一种高效、安全、方便的方法.     

念珠菌性龟头包皮炎的菌群分布与发病机理的研究

目的 :探讨念珠菌性龟头包皮炎的菌群分布、抗生素应用与念珠菌感染的关系及条件致病菌的主要来源。方法 :采用菌种收集、鉴定 ,回顾以往的用药史。结果 :念珠菌性龟头包皮炎的致病菌以外籍菌为主 ;长期、大量使用抗生素是诱发菌群失调使外籍菌成为优势菌的主要因素 ;念珠菌性龟头包皮炎的菌群分布与女性念珠菌性阴道炎的菌群分布成正相关。结论 :预防念珠菌性龟头包皮炎发生的重点应以采取安全的性行为、合理使用抗生素以降低诱发因素为主要措施。     

社区儿童包茎及并发包皮龟头炎相关因素分析

目的：分析社区儿童包茎及并发包皮龟头炎患病的相关因素。方法：回顾分析2013年11月—2014年11月在儿保门诊系统管理的男性儿童410人的资料。结果：410人男性儿童中1岁体检时患有包茎且并发包皮龟头炎273人,无包茎的137人。照看儿童人的年龄与儿童包茎及并发包皮龟头炎患病率有关,纸尿裤使用情况与儿童包茎及并发包皮龟头炎患病率有关,生殖器清洁护理情况与儿童包茎及并发包皮龟头炎患病率有关,无尿布疹儿童患包茎及并发包皮龟头炎患病率低。结论：应对照看儿童的家长加强健康教育,对儿童要进行科学的护理,降低儿童包茎及并发包皮龟头炎的发病率。