An unusual cause of multiple penile ulcers and balanoposthitis in a young male

Abstract

Balanoposthitis is a common inflammatory condition of the glans and prepuce among sexually active men in sexually transmitted diseases clinics. The common causes of this condition are infective, most commonly candidal, followed by bacterial and inflammatory. Among young uncircumcised men who are not sexually active, balanoposthitis may be the first clinical sign of underlying Type II diabetes mellitus (DM). Here, we present one such patient who presented with balanoposthitis and penile cellulitis. On initial workup, he was found to be a diabetic with poor control (HbA1c 11%), and on further investigations, he was found to have Staphylococcal balanoposthitis. He was initially managed with intravenous antibiotics, insulin therapy, and a dorsal slit of the prepuce, followed by circumcision, insulin, and oral hypoglycemic agents. DM should be suspected in all uncircumcised males presenting with balanoposthitis in the absence of positive contact history.