Penis peeling without pain or itching

The glans is an important part of the male reproductive organ, and this part is also very sensitive. The painless and itchy symptom of glans peeling is most likely caused by balanitis. Depending on the cause, it can be divided into many different types of balanitis. We need to have a comprehensive understanding of the situation and figure out the situation before we can determine the final cause based on our own situation.

Causes

Balanitis is related to many factors, which can be divided into infectious factors and non-infectious factors. Under normal circumstances, a large number of bacteria, yeasts and spirochetes can parasitize in the foreskin cyst, and when local or systemic resistance is weakened, these microorganisms can become pathogenic pathogens. It is mainly caused by bacteria, such as Escherichia coli, Staphylococcus, and Streptococcus, followed by Candida, Trichomonas, Mycoplasma, Chlamydia, and Gonorrhea, which can also cause foreskin and glans inflammation.

Non-infectious factors include stimulation from urine, alkaline substances (such as detergents) and foreign substances (such as condoms); friction and trauma; excessive foreskin and insufficient cleaning leading to accumulation of smegma, which can cause damage to the glans foreskin mucosa and aggravate infection by various pathogens.

Clinical manifestations

1. Acute superficial balanitis

It is mainly seen in young and middle-aged people with active sexual life, and the infecting bacteria are usually the same strain as the bacterial vaginosis of their sexual partners. At the beginning of the disease, the local skin becomes flushed and the glans penis feels burning and itchy. In the acute stage, if the foreskin is turned back, edema, erythema, erosion, exudation and bleeding can be seen on the glans penis. In severe cases, blisters may appear. If secondary infection occurs, ulcers may form, covered with purulent exudate, and local pain and tenderness may be obvious. Some patients may experience mild systemic symptoms, such as fatigue and weakness. In the chronic stage, only flake-like redness or porcelain-like cracks are seen on the inner layer of the foreskin and the coronal sulcus.

2. Annular ulcerative balanitis

It may be the early mucosal damage of Reites disease or it may be related to the long-term irritation of smegma. The clinical manifestations are erythema on the glans penis, which gradually expands and becomes ring-shaped or multi-ring-shaped, and may later form shallow ulcers. The main feature of this disease is one to several round lesions on the glans penis, with a red erosive surface in the middle and a white narrow band on the edge, connected into a ring shape. Secondary infection may worsen symptoms and cause the ring to lose its ring-like characteristics.

3. Candidal balanitis

It is caused by Candida infection, the most common being Candida albicans. The clinical manifestations are erythema of the foreskin and glans, smooth surface, slight desquamation around, scattered papules or pustules around, which slowly expand to the surrounding area. In the acute phase, edema, erythema, erosion, and exudation may occur. In severe cases, the disease may affect the penis, scrotum, inner thigh and groin. It is mostly caused by sexual contact, and may also be secondary to diabetes, wasting diseases, and long-term, large-scale antibiotic or hormone treatment.

4. Plasma cell balanitis

It is more common in middle-aged patients. Generally there are no obvious symptoms. The glans penis develops persistent, localized, infiltrative, dark reddish-brown patches with clear boundaries, smooth surface, many small red spots or erosions, easy bleeding, and no ulcers. Histopathology is diagnostic and is characterized by a band-like infiltration of inflammatory cells in the superficial dermis, interspersed with a large number of plasma cells.

5. Amebic balanitis

When the foreskin and glans become inflamed, the barrier function of the epithelium is lost, making it easy for amoeba infection to occur. The clinical manifestations are infiltrative erythema, erosion, shallow ulcers, obvious tissue necrosis and pain on the glans penis.

6. Mica and keratotic pseudoepitheliomatous balanitis

It is more common in patients over 50 years old and is often accompanied by phimosis. The skin of the glans penis is infiltrated and hypertrophic, with local hyperkeratosis and mica-like crusts, which are silvery white. The glans penis loses its normal elasticity and gradually shrinks.

7. Trichomonas balanitis

It is a mild, temporary erosive glans inflammation caused by Trichomonas infection. Patients often experience itching, which worsens during urination. Initially, erythema and papules appear on the glans penis with clear boundaries and gradually expand in scope. There may be small blisters ranging in size from needle tips to millet grains on the erythema. The blisters may expand and fuse with each other to form a mild erosive surface.

8. Balanitis sicca obliterans

The early stage of the disease is chronic balanitis, with thickened mucosa, ivory white lesion area, and desquamation of the epidermis. In the late stage, local atrophy occurs as scar-like growth. It can cause urethral stenosis and foreskin adhesion.