Talking about the common "glans penis disease" in outpatient department
1) pearl penile papulosis
In outpatient work, young men often come to see a doctor because of rows or rows of beaded papules the size of a needle tip on the glans penis. They are worried, some are worried about getting tumors, and some are afraid of getting sexually transmitted diseases. In the sexual medicine consultation letter, there are not a few people asking about the disease. They described it in detail: the rash is as big as a small grain of rice and almost the color of the surrounding skin. Although it has no effect on urination and sexual life, it is very stressful.
In fact, this disease is neither a tumor nor a sexually transmitted disease. Medical experts confirmed by pathological section that its structure is normal connective tissue hyperplasia. Medically named it guinea fowl papulosis.
The etiology of papulosis in guinea fowl is not clear, and the judgment mainly depends on the location and shape of rash distribution. There is no specific treatment for this disease, and there is no need for treatment. The most important thing for people with this disease is to understand this disease and get rid of fear and anxiety. This disease has no effect on the health and physiological function of penis.
2) white spots
White spots of different shapes can appear at the glans penis, some are all white, some are whiter, the surface is smooth without other rashes, and the surrounding pigments are often darker than normal skin color. There is no specific medicine for this disease, but it can often heal itself without treatment.
Because the white spot of glans penis is related to the chronic stimulation of echinococcosis, the white spot may become malignant, and those with phimosis or too long foreskin should be circumcised as soon as possible.
3) Hypertrophic erythema
It is characterized by single or several erythema on the glans penis, which can be round, annular or irregular, with clear boundary, slightly high and hard, and bright surface. Sometimes there may be erosion, scabbing or nipple-like hyperplasia. The disease may remain unchanged for many years, or it may become cancerous.
The etiology of hyperplastic erythema is unknown, but it mainly occurs in patients with long foreskin, so it is considered to be related to the stimulation of long foreskin and scales. The author has circumcised several patients with this disease, and the erythema of several of them naturally disappeared. Therefore, patients with this disease should be circumcised routinely. The treatment of hyperplastic erythema is still inconclusive. Some scholars advocate circumcision and close observation; Some doctors advocate freezing or x-ray irradiation of lesions.
In addition, this disease is also called erythema hyperplasia or red hypertrophy. Patients with erythema of glans penis should not be afraid to seek medical treatment. They should go to the urology department of the hospital for circumcision in the morning.
4) Skin angle
It is characterized in that there are horny protrusions on the glans with the thickness of matchsticks or chopsticks, which are brown or brownish gray and hard in texture. It is considered that it is a vegetation formed by the proliferation of epidermal keratinocytes on the basis of glans inflammation. Cutaneous horn is considered as a precancerous lesion.
The characteristics of skin angle are prominent, and the diagnosis is not difficult. The treatment is local excision. It should be pointed out that patients with keratosis glans should seek medical treatment as soon as possible, and never be embarrassed or try to remove it by themselves, so as not to aggravate the condition or delay the diagnosis and treatment, leading to serious consequences.
5) Vascular edema
Like urticaria, it is an acute allergic reaction caused by the bite of the glans penis to food, drugs or insects. This disease can only occur in the glans penis, and it can also occur at the same time as urticaria. Children are prone to edema of glans penis, which shows that the foreskin at the glans penis is highly edema and bright, like a big blister. But it does not affect urination. The disease often occurs at night, and the itching is not obvious, and there is no general discomfort. After a few days, it can subside on its own.
The simple diagnosis and treatment of vascular edema of glans penis foreskin is also easy, and the local area should be kept clean and dry. If necessary, gently wipe the focus with 1: 1000 bromogeramine. Patients with systemic urticaria can take chlorpheniramine and diphenhydramine orally, but under the guidance of a doctor.
6) Fixed drug eruption
Often due to oral sulfonamides, barbiturates, antipyretic and analgesic drugs, sudden onset occurs within one day or even a few minutes after taking the medicine. It is characterized by round or oval patches on the glans penis, with uncertain size, purple swelling in the center and red around, and itching or burning sensation in some parts. In severe cases, the central part quickly develops into a blister, which forms a wet and rotten surface after rupture. It takes more than ten days to heal, and there are many pigmentation, which will gradually fade after several months to a year. In the future, every time the patient takes sensitizing drugs, the rash on the affected area will recur and the area will become larger and larger.
The diagnosis of this disease is not difficult. If you have a history of taking medicine and have the above symptoms, especially a history of recurrence, it is easy to diagnose. It is not difficult to distinguish between glans penis drug eruption and vascular edema, and there is a history of drug abuse. Most of the more serious cases are drug eruption of glans penis.
Prevention of fixed drug eruption is more important than treatment. Patients should keep in mind their allergic drugs, take the initiative to explain when they see a doctor, and never use those drugs again. Once you get sick, you should stop taking sensitizing drugs immediately. If it is mild, antibiotic ointment can be used externally and diphenhydramine can be taken orally. Severe cases should be treated as soon as possible.
7) tinea cruris
It is more common in the buttocks and upper thighs, but it also often invades the penis. At first, it was diagnosed as a small papule (papule), itching, and then it expanded to form a round or polymorphic skin lesion with a ring-shaped bulge at the edge and a flat center, which is common in desquamation.
Tinea cruris is a fungal infection. It is not difficult to diagnose according to the symptoms. When in doubt, we can scrape a little dander from the skin lesions and look for fungal hyphae under the microscope, which is helpful for diagnosis.
The skin on the penis is thin and tender, so it is not appropriate to treat it with drugs that are too irritating. Generally, clotrimazole ointment can be used externally, and the effect is good. If there is tinea in other parts, it should be treated at the same time to avoid recurrence.
8) tuberculosis rash
Often occurs in the glans penis, showing red papules (papules), painless and slow progress. Sometimes it breaks to form a small round ulcer without pus, which can gradually scar and heal. Sometimes it can be combined with skin tuberculosis rash, which is characterized by multiple rashes on limbs, back, head and neck, and is easily misdiagnosed as acne, folliculitis or cyst. Rashes come and go and can be absorbed by themselves, but each rash usually takes about 20-30 days to heal itself.
Tuberculosis rash of glans penis can be diagnosed according to the characteristics of rash, tuberculosis or tuberculosis contact history of patients and typical rashes in other parts. It should be pointed out that tuberculosis rash is caused by the allergic reaction of skin to tuberculosis lesions in other parts, and the lesions themselves do not contain mycobacterium tuberculosis.
The treatment of tuberculosis rash should be oral anti-tuberculosis drugs, not private treatment for patients. You should ask a doctor for guidance on medication.
9) Condyloma Acuminatum
It often occurs from 3 weeks to 8 months after sexual contact, and the lesions are located in the penis head, coronary sulcus, prepuce frenulum, urethral orifice and so on. It is characterized by soft papillary papules, gray, yellowish or pink, and it is easy to bleed when touched. It can be single or densely clustered, which is a bit like the pattern of vegetables. Treatment requires cryotherapy or laser therapy.
10) molluscum contagiosum
It usually occurs 2-7 weeks after sexual contact, and it is a hemispherical papule with a diameter of 3-6 mm and a slightly concave center like an umbilical fossa. If you squeeze a papule, you can squeeze out a white cheese-like substance. Treatment can be scraped off with a sharp curette, then coated with iodine or carbolic acid and pressed to stop bleeding; Cryotherapy can also be used.
1 1) fungal balanitis
It is caused by a mold called Candida, which usually occurs in circumcised patients. Its glans is red and shiny, with small pustules or papules on its surface. You can take clotrimazole or ketoconazole and apply clotrimazole ointment to the lesion.
12) psoriasis
It can only happen in the penis, but not in other parts, so it is not easy to identify. It is characterized by erythema papules with clear edges on the penis head, and there are no silvery scales peculiar to psoriasis. If it grows on the penis shaft, it may have scales. Hydrocortisone ointment can be used externally to control diseases.
Villous papilloma
There are miliary masses on the edge of the coronary sulcus, which are pink nipples and arranged in rows; When the penis is erect, the protrusion is particularly obvious and hard. Usually there is no pain and other discomfort, but it will damage the woman's vaginal mucosa during sexual life. Treatment requires surgical local resection.
14) balanus dermatitis
This is a kind of glans prepuce disease with the highest incidence. Almost all patients have phimosis or redundant prepuce. Between glans penis and prepuce, shed epithelial cells, glandular secretions and echinococcosis form a warm and humid bacterial culture medium, which can cause inflammation once bacteria enter.
In the early stage of balanoposthitis, balanoposthitis, edema and congestion on the prepuce surface, swelling and erosion around the urethral orifice and wound surface can be seen, which can develop into superficial ulcer with purulent secretion flowing out, and the patient consciously feels the penis head.
Itching or burning sensation followed by pain. After festering, it can fester and stink. In severe cases, there will be fatigue, low fever, swollen inguinal lymph nodes and tenderness.
In addition, if it is candidal balanitis infected by mold, it often shows erythema, local edema, smooth appearance, slight desquamation at the edge of the glans, papules and pustules can spread around, forming glans erosion. Recurrent candidal balanitis can cause chapped prepuce, fibrosis and sclerosing changes of glans.
Treatment of balanoposthitis: local use of 1:5000 potassium permanganate bath can soak balanoposthitis once in the morning and once in the evening, or swab with 1: 1000 bromogeramine to gently rub exudate or pus. Be careful not to use all kinds of ointments and powders, otherwise it will easily aggravate the condition. Those with severe systemic reaction can be treated with antibiotics. When the general treatment effect is not obvious, attention should be paid to the diagnosis and treatment of special pathogenic microorganisms. If candida is found in secretion, nystatin or clotrimazole should be given locally. If trichomonas is detected in the secretion, metronidazole should be taken orally. When sexually transmitted diseases are suspected, Neisseria gonorrhoeae should be checked in secretions and differentiated from hard chancre and soft chancre.
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