Summary
Definition
History and exam
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
Treatment algorithm
Contributors
Authors
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 has received honoraria as European Society of Urology speaker. He is an author of a number of references cited in this topic.
Peer reviewers
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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