Genital skin lesions

Genital skin lesions

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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.

• 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

Acknowledgements

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