Balanoposthitis in Penile Intraepithelial Neoplasia (PeIN) with HPV Infection or Lichen Sclerosus

This protocol covers balanoposthitis occurring in the context of penile intraepithelial neoplasia (PeIN) — a distinct clinical scenario with a strong association with human papillomavirus (HPV) infection and/or lichen sclerosus.

PeIN cases in this setting are strongly associated with human papillomavirus infection and/or lichen sclerosus. The risk is further elevated when concomitant immune-incompetence is present — for example in untreated HIV infection, in organ transplant recipients, or in patients receiving small-molecule or biologic immunosuppressants.

When topical treatments have not achieved adequate control, the management approach may escalate to a surgical intervention targeting the glans. The full criteria for escalation, the complete sequence of options, and the supporting evidence are detailed in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jdv.18954

They are strongly associated with human papillomavirus infection and/or lichen sclerosus.

The risk is increased if there is concomitant immune-incompetence such as in untreated HIV, in organ transplant patients or in those treated with small molecule (e.g. azathioprine, cyclosporin, methotrexate and leflunamide) or biologic immunosuppressants.

Glans-resurfacing (generally, if topical treatments have failed) (2,D)

View source ↗