balanitis xerotica et obliterans

Last reviewed 05/2019

Balanitis xerotica et obliterans refers to thickening and depigmentation of the foreskin which is often adherent to the glans penis. The cause is unknown (possible autoimmune pathogenesis) (1).

May be asymptomatic. Patients could present with itching, dyspareunia, white patches on the glans often with involvement of the prepuce, meatal thickening and narrowing (1).

Elsewhere in the body, the condition may be known as lichen sclerosus.

Diagnosis is through clinical features and biopsy (1).

Treatment is with

  1. topical steroid creams – used once daily until remission and then gradually tapered
  2. treatment of secondary infection
  3. circumcision – in phimosis and resistant cases
  4. surgery for meatal narrowing.

All patients are adviced to do a follow up annually in view of the risk of malignant transformation (1).