The Study Of Skin Barrier And Microflora Distribution In Prepuce And Glans Penis Of Patients With Non-candida Balanoposthitis

Background: Balanoposthitis is a common genital disease in men.Inflammation involving glans penis and prepuce is called balanoposthitis.Candida infection accounted for about 32%.Antifungal agents are the correct method to treat candida balanoposthitis.However,there is no scientific diagnosis and targeted treatment for non-candida balanoposthitis.At present,there are no objective clinical indicators for evaluating the severity of balanoposthitis.Clinical examination and lesion involvement may be subjective in evaluating the severity of the disease.Changes in bacterial flora and impaired barrier function on skin surface are found in inflammatory skin diseases such as psoriasis,atopic dermatitis,acne and rosacea,and there is a link between bacterial flora and barrier function.At present,there is no correlation study on skin barrier function and bacterial flora distribution in patients with balanoposthitis.To explore the etiology,the skin barrier function and bacterial flora distribution of patients were measured before and after treatment.Fusidic acid,Lactobacillus and moisturizer were used to observe the curative effect and the effect on barrier function and bacterial flora,and to explore new therapeutic method.Methods: In this study,30 non-candida balanitis patients with clinical manifestations of balanoposthitis and negative fungal microscopic results were selected.32 healthy volunteers without skin rash on the glans penis and prepuce were selected and divided into two groups according to the length of prepuce: the redundant prepuce group and the normal group.The trans-epidermal water loss(TEWL),skin hydration and p H value in the glans penis and prepuce were detected in patients and healthy subjects.The patients were randomly divided into three treatment groups: A(fusidic acid plus moisturizer),group B(Lactobacillus plus moisturizer)and group C(fusidic acid plus Lactobacillus plus moisturizer).Skin barrier function was measured after 10 days of treatment.The distribution of bacterial flora in the redundant prepuce group,normal group and three treatment groups was detected.This study was approved by the Ethics Committee of the First Affiliated Hospital of China Medical University(Approval No.[2018] 2018-193-2).Results: Compared with the normal group and the non-lesion group,TEWL increased significantly in the lesion sites.Compared with the normal group,TEWL and skin hydration increased significantly in the redundant prepuce group.Compared with the lesion and non-lesion sites,the skin hydration increased significantly in the redundant prepuce group.Compared with healthy subjects and patients with non-lesion sites,the p H value of lesion sites increased,the difference was statistically significant.There was no significant difference in p H value between healthy subjects and patients at non-lesion sites.The scores of symptoms in the three groups decreased,and some patients' symptoms disappeared completely.There was no difference in the efficiency of the three treatments.Streptococcus and Staphylococcus had low abundance in each sample.The abundance of Finegoldia and Prevotella in patients and healthy subjects changed significantly after treatment.Compared with the normal group,Anaerococcus and Peptoniphilus are more abundant in patients,and decreased after treatment.Lactobacillus exists in all samples,and the abundance of Lactobacillus increases in the samples whose symptoms disappear completely after treatment with Lactobacillus.Conclusion: Finegoldia and Prevotella are suspicious pathogens of non-candida balanoposthitis.Increased abundance of anaerobic bacteria may affect the occurrence and development of diseases.Skin barrier function was impaired in the lesions of patients and redundant prepuce group.The related indicators of skin barrier function can be used to evaluate the severity of the disease in patients with non-candida balanoposthitis.External application of Lactobacillus,fusidic acid cream and moisturizer is effective in treating non-candida balanoposthitis.It shows that barrier dysfunction and dysbacteriosis play a role in the occurrence and development of the disease.There is no difference between the three treatment.