Glans headache

Introduction Turtle headache is a common type of male disease, usually caused by balanitis. Balanitis refers to inflammation of the skin of the penis head. A kind of lipid substance secreted in the normal foreskin cavity. When the foreskin is too long or phimosis, such substances can accumulate into smegma to stimulate the foreskin and glans to cause foreskin balanitis, causing various infection symptoms in male penis.

Cause

1, caused by foreskin balanitis: the appearance of the erythema of the glans, the surface usually has small pustules or small papules.

2, the foreskin is too long: the unclean things between the foreskin and the glans, that is, smegma, will accumulate, stimulating local foreskin and mucous membrane inflammation.

3, unclean sex life: infected with Candida albicans, trichomoniasis, chlamydia, mycoplasma, gonorrhea or other bacteria.

an examination

Related inspection

Smear foreskin phimosis

1, check the test: Candida balanitis (the dermatitis) can be found in the lesions of the glans, foreskin microscopic examination or culture can be found Candida. Trichomonas balanitis can find trichomoniasis on secretions.

2, direct microscopic examination: scrape the surface scale of the glans glans, coronary sulcus or foreskin as the specimen to be examined. The specimens to be inspected were made with 10% potassium hydroxide or physiological saline, and clusters of egg-shaped spores and pseudohyphae were observed under the microscope. If more pseudohyphae were found, it indicated that Candida was in the pathogenic stage.

3, staining examination: Gram staining, Congo red staining or PAS staining after microscopic examination, the positive rate is higher than direct microscopy. Gram staining, spores and pseudohyphae dyed in blue: Congo red and PAS staining, spores and pseudohyphae dyed red.

4. Separation and culture: Candida culture can be performed on patients with negative smear test. The test specimens were inoculated on Sabouraud medium under aseptic conditions. When inoculation, the test tube culture medium was cut obliquely, and each tube was inoculated with 2-3 spots, and each sample was inoculated with 2 tubes. The medium was incubated in a 37 ° C incubator for 24-48 hours, and a large number of milky white colonies were observed. A small number of colony smears were picked with the inoculation needle, and microscopic examination or microscopic examination was performed. A large number of spores were observed. Diagnosed as a Candida infection.

Differential diagnosis

1, acute superficial balanitis (acute superficial balanitis) is an acute inflammation of the glans, often caused by trauma, friction, soap, detergent and other local stimulation. Mainly manifested as local edematous erythema, erosion and exudate, blister and bullae may occur in severe cases. After the bacterial infection, the ulcer surface is formed and there is purulent secretion. The above symptoms can be caused by local friction, poor foreskin turnover, accumulation of secretions, and stimulation of the wound to aggravate inflammation. Conscious pain and tenderness. Local inflammation is significant and may be associated with mild systemic symptoms.

2, annular erosive balanitis (circinate erosive balanitis) clinical manifestations of two types. One is the early manifestation of Reiter's disease; the other is persistent, recurrent balanitis with ring or multiple ring lesions. At the beginning, the erythema at the glans and foreskin is gradually enlarged, and it is ring-shaped or multi-ringed, and forms a superficial ulcer surface later. Patients with poor foreskin turnover due to local accumulation of secretions, often secondary infections make the symptoms worse, lose their ring characteristics and are not easy to distinguish from superficial ulcers.

3. Candidal balanitis Candida balanitis can be primary or secondary. The latter is often secondary to diabetes, aging debilitating diseases and antibiotics and hormone therapy. The clinical manifestations are erythema, smooth surface, mild desquamation on the edge, and satellite-like distribution of herpes and small pustules, which slowly expand to the periphery, and the boundary is generally clear. The groin can also be involved. In the acute attack, the glans mucosa is edematous erythema, the boundary is unclear, and there may be erosion and exudation. Candida can be found by microscopic examination and culture of the lesion. Repeated episodes of Candida balanitis can cause dry skin, fibrosis and hardening changes.

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