Last reviewed: November 2017
Last updated: March  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • uncircumcised state

Other diagnostic factors

  • multiple sexual partners
  • high-risk sexual behaviours
  • post-inflammatory hypo- or hyper-pigmentation
  • pruritus
  • red scaly patches
  • erosions
  • personal/family history of atopy (eczema, hay fever, asthma, type I allergies)
  • personal/family history of psoriasis
  • urinary dribbling
  • hypo-pigmentation
  • purpura
  • red plaques
  • blisters
  • papules or micro-papules
  • pustules

Risk factors

  • congenital or acquired dysfunctional foreskin
  • uncircumcised state
  • poor hygiene; urinary dribbling or leakage
  • over-washing
  • human papillomavirus (HPV) infection
  • inflammatory skin diseases
  • Borrelia infection

Diagnostic investigations

1st investigations to order

  • swab for microbiology (Gram stain and culture) and PCR
  • swab for virology
  • dark-field microscopy
Full details

Investigations to consider

  • skin biopsy
  • patch testing
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Dermatologist

St Mary's Hospital

Imperial College Healthcare NHS Trust

London

UK

Disclosures

IC declares that he has no competing interests.

Consultant Genitourinary Physician

Chelsea and Westminster Hospital

London

UK

Disclosures

DH declares that he has no competing interests.

Consultant Dermatologist

Honorary Professor of Dermatology

University College London

Chelsea & Westminster Hospitals

London

UK

Disclosures

CB is an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Consultant in Sexual Health

Department of Sexual Health

Countess of Chester Hospital NHS Foundation Trust

Chester

UK

Disclosures

CO declares that he has no competing interests.

Consultant

Department of GU Medicine

West Suffolk Hospital

Suffolk

UK

Disclosures

SE declares that she has no competing interests.

Consultant Dermatologist and Honorary Senior Lecturer

Dermatology Department

The Royal London Hospital

London

UK

Disclosures

DP declares that he has no competing interests.

Chief Dermatology Resident

University of California

Irvine

CA

Disclosures

JW declares that he has no competing interests.

Assistant Professor of Medicine

Division of Infectious Diseases

University of Vermont College of Medicine

Burlington

VT

Disclosures

CH declares that he has no competing interests.

Clinical Professor of Dermatology

Columbia University College of Physicians and Surgeons

New York City

NY

Disclosures

NS declares that she has no competing interests.

Associate Professor of Dermatology and Dermatology Residency Program Director

Boonshoft School of Medicine

Wright State University

Dayton

OH

Disclosures

Speaker's Bureau, Stiefel; Consultant, Abbott.

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