Balanitis circinata

Medically reviewed by The Dermatologists and written by Dr. Carol Mastropierro and Dr. Alexander Börve

Balanitis circinata also known as circinate balanitis is a form of skin inflammation of the glans penis in males with post-infectious arthritis. It is most commonly seen with genitourinary chlamydia induced arthritis and rarely after gastrointestinal infections. In roughly half of the patients with reactive arthritis, the causative pathogen responsible for the infection cannot be identified. In such cases, the presence of circinate balanitis is useful to differentiate reactive arthritis from poststreptococcal, rheumatic fever, or viral arthritis.

This condition is commonly associated with Reiter’s syndrome. Reiter’s syndrome is a systemic rheumatic disease, which affects not only the joints, but may also cause inflammation in areas such as the eyes, mouth, lungs, kidneys, heart, and skin.

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Symptoms 

Balanitis Circinate presents with small and shallow painless ulcers near the urethral meatus or on the glans penis. The characteristic lesions are circinate or gyrate white plaques that grow centrifugally and eventually cover the entire surface of the glans penis. The penile shaft and scrotum can also be involved. 

Initially, the presentation is by pin-sized dots with white plaque on them which constantly grow into flat, red areas. Patients do not report any pain, nor suffer from burning or itching. Discharge or bad smells are not present. On an uncircumcised penis, the lesions typically remain moist and unchanged, whereas on a circumcised penis, the palques may harden and crust. In this case pain and scarring occur in half of the patients.

Balanitis circinata is often misdiagnosed as a mycosis due to its similarities to fungal infection, especially if the patient does not have any signs of Reiter’s or joint involvement. 

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What can I do 

Balanitis circinata is usually a symptom to another condition. Although it may not provoke any discomfort or pain, you should address these changes to your GP or Dermatologist. It is important to promote hygienic measures and avoid scented or harsh intimate washes, this is in order to avoid exacerbations of the infection on such sensitive skin.

Consult an online dermatologist today and get an answer on your skin concern within hours.

Treatment 

Although circinate balanitis by itself usually does not require treatment, it can serve as an indicator of underlying genitourinary infections or rheumatological disease. In refractory patients, or in patients with visible inflammation of the glans penis, topical salicylates or mild topical glucocorticoids are used. 

Consult an online dermatologist today and get an answer on your skin concern within hours.

Source: 

Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267749/

Robert Carney, St Peters Health Centre, Department of GUM — Sexual Health Clinic: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408497/

Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD: https://www.medscape.com/answers/331347-112104/what-are-findings-of-circinate-balanitis-in-patients-with-reactive-arthritis-rea