A. Kiss et al., The response of balanitis xerotica obliterans to local steroid applicationcompared with placebo in children, J UROL, 165(1), 2001, pp. 219-220
Purpose: We evaluated the clinical effectiveness of topical steroid applica
tion for balanitis xerotica obliterans in children and analyzed the associa
tion of any clinical response with histological findings.
Materials and Methods: Our double-blind, placebo controlled, randomized stu
dy included 40 boys in whom balanitis xerotica obliterans was diagnosed cli
nically by cicatricial phimosis. The severity of phimosis was graded into 4
groups. Patients were randomized to receive the topical application of 0.0
5% mometasone furoate or placebo. After 5 weeks phimosis severity was reeva
luated and all patients underwent circumcision. Surgical specimens were his
tologically typed as an early, intermediate or late form of balanitis xerot
ica obliterans.
Results: Seven patients were withdrawn from the study. In the steroid group
7 boys had clinical improvement and 10 had no change. Histological study s
howed an early, intermediate and late form of balanitis xerotica obliterans
in 5, 5 and 7 cases, respectively. Of cases with clinical improvement 5 we
re the early and 2 the intermediate type. In the placebo group 5 cases wors
ened clinically and 11 did not change. Histological evaluation revealed an
early, intermediate and late form of balanitis xerotica obliterans in 3, 7
and 6 boys, respectively. Of the 5 cases with histological worsening, disea
se was the early, intermediate and late type in 2, 2 and 1, respectively.
Conclusions: Applying a potent topical steroid affects improvement in balan
itis xerotica obliterans in the histologically early and intermediate stage
s of disease, and may inhibit further worsening in the late stage.