Follmann reported a balanitis in patients with primary syphilis. This is a rare condition that may be the only clinical finding in primary syphilis.
The patient gives a history of being sexually-active.
The appearance of the glans may include:
(1) diffuse indurated dark red erythema of the glans
(2) erosive balanitis
(3) diffuse cardboard-like induration
(4) crusted balanitis
A patient may or may not have had a primary chancre. If a chancre develops, it may precede or be concurrent with the balanitis.
Additional findings:
(1) bilateral inguinal lymphadenopathy
(2) positive serologic or molecular tests for syphilis
(3) variable presence of other sexually-transmitted diseases (HSV, other)
(4) variable presence of other pathogens (Candida, Staphylococcus aureus)
