價Check for updatesReceived:27October 2022 Accepted:1 February 2023D0L:10.11110dw.18954JEADVGUIDELINES2022 European guideline for the management of balanoposthitisSarah K.Edwards'Christopher B.Bunker Eric M.van der Snoek'Willem I.van der Meijden'iCasH Suffolk,Abbey View Clinic,Bury StEdmunds,UKAbstractDepartment of Dermatology.UniversityBackground:This guideline is an update to the 2014 edition of the European guide-College London Hospitals,London,UKline for the management of balanoposthitis.Balanoposthitis describes inflammationDepar tment of Dermatology.Centralof the glans penis and prepuce and is caused by a range of disparate conditions in-Military Hospital,Utrecht,The Nethe rlandsDepartment of Dermatology.Betsicluding infection,dermatoses and premalignancy.Cadwaladr University Health BoardObjective:The main objectives of this guideline are to aid recognition of the symp-(BCUHB),Bangor,UKtoms and signs and complications of penile skin conditions and to offer recommen-dations on the diagnostic tests and treatment for a selected group of these conditions.Cor respondenceSarah K.Edwards,iCasH Suffolk,Abbey ViewMethods:The previous guideline was updated following a literature review and pri-Clinic,9-10 Churchyard,Bury St Edmundsority was given to randomized controlled trial and systematic review evidence.IP33 1RX,UKResults:The updated guideline includes amended management for infective balanitis toEmail:sarah.edwards6@nhs.netprovide clear guidance for Group A streptococcal infections,management of on goingLichen sderosus(to include circumcision and supportive management to reduce therecurrence of genital herpes and warts),additional regimens for Zoonoid change,use ofcalcineurin inhibitors in management and risk of premalignancy and change of nomen-claturefrom Premalignant conditions to Penile Intraepithelial neoplasia(PeIN).Conclusion:Balanoposthitis hasa widerange of causes high quality evidence specificto the management of penile disease is not available for all the conditions described.INTRODUCTIONPsoriasis and circinate balanitisSeborrheic dermatitisThe main objective of this guideline is to aid recognition ofIrritant/Allergic eczemathe symptoms and signs and complications of penile skin·Fixed drug eruptionsconditions that may present to a variety of clinical specialtiesPre malignancy or suspected malignancyin Europe,including dermatology,sexual health and urol-ogy'and provide recommendations on therapeutic treatmentIt is not intended as a comprehensive review of the treat-and management Appendices 1 and 2.It is not intended as ament of all forms of balanoposthitis.It is aimed primarily atcomprehensive review of the treatment of all forms of bala-managing penile conditions in people aged 16 years or older.noposthitis.In view of the breadth of the topic,this guidelineconcentrates on the following selected group of conditions,which were identified as being either common or significant'AETIOLOGIESand which may be managed by clinicians primarily pr
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