title: The response of balanitis xerotica obliterans to local steroid application compared with placebo in children.
abstract: OBJECTIVE
  We evaluated the clinical effectiveness of topical steroid application for balanitis xerotica obliterans in children and analyzed the association of any clinical response with histological findings.
  
  
  METHODS
  Our double-blind, placebo controlled, randomized study included 40 boys in whom balanitis xerotica obliterans was diagnosed clinically by cicatricial phimosis. The severity of phimosis was graded into 4 groups. Patients were randomized to receive the topical application of 0.05% mometasone furoate or placebo. After 5 weeks phimosis severity was reevaluated and all patients underwent circumcision. Surgical specimens were histologically typed as an early, intermediate or late form of balanitis xerotica 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  Seven patients were withdrawn from the study.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 showed an early, intermediate and late form of balanitis xerotica obliterans in 5, 5 and 7 cases, respectively. Of cases with clinical improvement 5 were the early and 2 the intermediate type. In the placebo group 5 cases worsened 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, disease was the early, intermediate and late type in 2, 2 and 1, respectively.
  
  
  CONCLUSIONS
  Applying a potent topical steroid affects improvement in balanitis xerotica obliterans in the histologically early and intermediate stages of disease, and may inhibit further worsening in the late stage.
authors: Departments of Urology and Pathology, Heim Pál Children's Hospital, Budapest, Hungary.
authors: A
authors: A
authors: Kiss
authors: A
authors: A
authors: Csontai
authors: L
authors: L
authors: Pirót
authors: P
authors: P
authors: Nyirády
authors: M
authors: M
authors: Merksz
authors: L
authors: L
authors: Király
mesh_terms: D000287:Administration, Topical; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001446:Balanitis / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D002944:Circumcision, Male; D004311:Double-Blind Method; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D000068656:Mometasone Furoate; D010413:Penis / Q000473:pathology; D010688:Phimosis / Q000473:pathology; D011244:Pregnadienediols / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011244:Pregnadienediols; D000068656:Mometasone Furoate