#july2020amc1
A 9-year-old boy presents with a non-retractile foreskin. He does not currently have any urinary symptoms. On examination the foreskin is thickened, white and stiff. Which one of the following is the most appropriate next step?
A. Circumcision
B. Oral steroids
C. Topical betnovate cream
D. Waiting until post puberty to reassess
Explanatory Notes:
The history points to balanitis xerotica obliterans. This is a progressive scarring condition and requires a circumcision for definitive treatment.
A - correct
B - oral steroids have no place in the management of this localised disease
C - Betnovate cream may control the symptoms for a short period but is not definitive.
D - there is no advantage in waiting and there is a small risk of urinary symptoms progressing to the point of urinary retention
A 9-year-old boy presents with a non-retractile foreskin. He does not currently have any urinary symptoms. On examination the foreskin is thickened, white and stiff. Which one of the following is the most appropriate next step?
A. Circumcision
B. Oral steroids
C. Topical betnovate cream
D. Waiting until post puberty to reassess
Explanatory Notes:
The history points to balanitis xerotica obliterans. This is a progressive scarring condition and requires a circumcision for definitive treatment.
A - correct
B - oral steroids have no place in the management of this localised disease
C - Betnovate cream may control the symptoms for a short period but is not definitive.
D - there is no advantage in waiting and there is a small risk of urinary symptoms progressing to the point of urinary retention
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