{ "schema_version": 1, "kind": "condition", "id": "phimosis", "name": "Phimosis (Symptomatic)", "category": "chronic", "sources": "EAU Guidelines on Paediatric Urology 2023 for the indication, with the product from Diprosone 0.05 % w/w Cream (betamethasone dipropionate) SmPC sections 2 and 4.2 (eMC product 6405): \"Betamethasone dipropionate 0.064% w/w* (* equivalent to 0.05% betamethasone)\" and \"Adults and Children: Once to twice daily. In most cases a thin film of Diprosone Cream should be applied to cover the affected area twice daily.\" The SmPC carries no phimosis indication and states no 4 to 8 week course; those are from the EAU guideline, which is not held in this corpus. · EAU Guidelines on Paediatric Urology 2023 · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103)", "review_status": "reviewed", "verified_against": "EAU Guidelines on Paediatric Urology 2023 for the indication, with the product from Diprosone 0.05 % w/w Cream (betamethasone dipropionate) SmPC sections 2 and 4.2 (eMC product 6405): \"Betamethasone dipropionate 0.064% w/w* (* equivalent to 0.05% betamethasone)\" and \"Adults and Children: Once to twice daily. In most cases a thin film of Diprosone Cream should be applied to cover the affected area twice daily.\" The SmPC carries no phimosis indication and states no 4 to 8 week course; those are from the EAU guideline, which is not held in this corpus. · EAU Guidelines on Paediatric Urology 2023 · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · Phimosis - disease-level clinical article (phimosis-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1400, "generic": "Betamethasone dipropionate", "line": 1, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply thin layer of 0.05% cream to tight prepuce twice daily for 4-8 weeks alongside gentle manual foreskin retraction", "adult_duration": "4-8 weeks", "dose_source": "EAU Guidelines on Paediatric Urology 2023 for the indication, with the product from Diprosone 0.05 % w/w Cream (betamethasone dipropionate) SmPC sections 2 and 4.2 (eMC product 6405): \"Betamethasone dipropionate 0.064% w/w* (* equivalent to 0.05% betamethasone)\" and \"Adults and Children: Once to twice daily. In most cases a thin film of Diprosone Cream should be applied to cover the affected area twice daily.\" The SmPC carries no phimosis indication and states no 4 to 8 week course; those are from the EAU guideline, which is not held in this corpus.", "rationale": "Betamethasone is a potent topical corticosteroid applied to the tight foreskin to reduce local inflammation and improve tissue elasticity, helping gentle retraction succeed and potentially avoiding surgical circumcision.", "cautions": [ "Physiological phimosis is normal in infants and young boys up to 3 years; do not force retraction.", "Avoid long-term uninterrupted topical steroid application to prepuce to prevent skin atrophy.", "Refer to urology for surgical circumcision if medical therapy fails or if recurrent balanitis/paraphimosis occurs." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply thin layer to narrow prepuce twice daily for 4-8 weeks with gentle retraction", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DIPROSONE 0.05% CREAM 10 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": 10000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIPROSONE 0.05% OINT. 10 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 26.0, "pack_count": null, "unit_price": null, "strength_mg": 10000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DIPROSONE 0.05% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 45.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "phimosis" }, { "id": 1402, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Phimosis - disease-level clinical article (phimosis-full.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Acute urinary retention or nocturnal enuresis from chronic outflow obstruction is a rare but serious presentation of BXO-related phimosis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "phimosis" }, { "id": 1401, "generic": "Hydrocortisone", "line": 2, "is_adjunct": false, "form": "topical", "strength_mg": null, "adult_dose": "Apply thin layer of 1% cream to prepuce twice daily", "adult_duration": "4-6 weeks", "dose_source": "Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103)", "rationale": "Hydrocortisone is a milder topical corticosteroid used in young children to loosen a tight foreskin and support gentle retraction, chosen for its lower potency and better safety margin in children compared with betamethasone.", "cautions": [ "Discontinue once foreskin is comfortably retractable.", "Limit a course in a child to 7-10 days, and remember the face and scalp absorb far more than limb skin.", "Hydrocortisone is a milder steroid option for young children." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Apply thin layer twice daily for 4-6 weeks for mild foreskin tightness", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NOVACORTIN 1% CREAM 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NOVACORTIN 1% OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MICORT 1% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 12.5, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HYDROCORTISONE 1% OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "phimosis" } ] }