Genital skin lesions
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Genital skin lesions can be anything from simple irritation to a sexually transmitted disease to a malignancy. History and physical examination are critical for appropriate diagnosis
Differential Diagnosis
In alphabetical order. [1] [2]
- Behcet syndrome
- Candida Intertrigo
- Chancroid
- Condyloma Acuminatum
- Erythrasma
- Extramammary Paget’s disease
- Fixed drug eruptions
- Genital Squamous Cell Carcinoma
- Granuloma Inguinale
- Herpes Simplex Virus (HSV)
- HIV
- Inverse Psoriasis
- Lichen Planus
- Lymphogranuloma Venereum
- Molluscum Contagiosum
- Plaque Psoriasis
- Scabies
- Seborrheic Dermatitis
- Syphilis
- Tinea Cruris
- Zoon’s plasma cell balanitis
Diagnosis
History and Symptoms
- Appearance of lesion
- Description of change in lesion
- Presence of pain and/or itching
- Sexual history
Physical Examination
- Complete skin and genital examinations
Laboratory Findings
- Viral culture
- Tzanck test
- Rapid plasma reagin (RPR)
- Venereal Disease Research Laboratory test (VDRL)
- Fluorescent treponemal antibody absorbed (FTA-ABS)
- Culture or Gram stain
- HIV workup
- Syphilis workup
- Pregnancy test
- Hepatitis B and Hepatitis C workup
Other Diagnostic Studies
- Biopsy
- Shaved biopsy
Treatment
- Cool baths
- Podophyllin
- Cryotherapy
- Cantherone
- Trichloroacetic acid
- Laser (ablate lesions)
Acute Pharmacotherapies
- Antivirals
- Acetaminophen
- Nonsteriodal anti-inflammatory drugs (NSAIDs)
- Topical immunotherapy
- Topical or oral antifungals
- Antibiotics
- Topical steroids
Surgery and Device Based Therapy
- Biopsies (after topical therapy)
- Surgical removal of lesions
References
Acknowledgements
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List of contributors:
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