Differentials
Allergic reactions
SIGNS / SYMPTOMS
History of changes in detergents, or use of new clothing, or cleansing agents in infants, can direct the clinician to the potential for an allergic reaction.
INVESTIGATIONS
Positive patch test.
Avoidance of presumed irritant should ameliorate the symptoms.
Insect bites
SIGNS / SYMPTOMS
History of exposure to insects (or spiders) should raise the suspicion of insect bites as the cause of penile and foreskin swelling. Additionally, many bites are associated with early onset of necrosis of tissue. Pruritus is often a prominent sign. The site of the bite or sting may be visible.
INVESTIGATIONS
Antihistamines should reduce redness and swelling.
Tourniquet syndrome
SIGNS / SYMPTOMS
Presence of constricting ring. Use of penile constricting rings to enhance erection by compression of the corpora can also lead to constriction of the glans and foreskin. Sometimes the ring may be so deeply buried in the oedematous tissue as to be almost invisible.
INVESTIGATIONS
Examination of the penis.
Hair coil strangulation
SIGNS / SYMPTOMS
Presence of hair coil. In infants, hair coil strangulation can lead to significant injury of the corpus and distal oedema of the glans. The hair coil, typically from maternal hair, can be buried in the oedematous tissue and can be difficult to identify.
INVESTIGATIONS
Examination of the penis.
Use of this content is subject to our disclaimer