Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presença de fatores de risco
- estado não circuncisado
Otros factores de diagnóstico
- múltiplos parceiros sexuais ou comportamentos sexuais de alto risco
- hipo ou hiperpigmentação pós-inflamatória
- prurido
- descamação vermelha
- erosões
- história pessoal/familiar de atopia (eczema, febre do feno, asma, alergias do tipo I)
- história pessoal/familiar de psoríase
- gotejamento urinário
- hipopigmentação
- púrpura
- placas vermelhas
- vesículas
- pápulas ou micropápulas
- pústulas
Factores de riesgo
- prepúcio disfuncional congênito ou adquirido
- estado não circuncisado
- higiene deficiente, gotejamento e perda de urina
- lavagem excessiva
- infecção por papilomavírus humano (HPV)
- doenças cutâneas inflamatórias
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- swab para microbiologia (coloração de Gram e cultura) e teste de amplificação de ácido nucleico (NAAT)
- swab para virologia
- microscopia de campo escuro
Pruebas diagnósticas que deben considerarse
- biópsia de pele
- teste de contato
Pruebas emergentes
- dermatoscopia
Algoritmo de tratamiento
eczema atópico
dermatite seborreica
dermatite de contato irritativa (DCI)
dermatite alérgica de contato
psoríase
artrite reativa (doença de Reiter)
líquen escleroso
gonorreia
candidíase
balanopostite inespecífica
Balanite de Zoon
carcinoma in situ/neoplasia intraepitelial peniana (NIP)
Colaboradores
Autores
Ien Chan, MD, FRCP
Consultant Dermatologist
Chelsea and Westminster Hospital
London
UK
Divulgaciones
IC declares that he has no competing interests.
David Hawkins, FRCP
Consultant Genitourinary Physician
Chelsea and Westminster Hospital
London
UK
Divulgaciones
DH declares that he has no competing interests.
Christopher B. Bunker, MA, MD, FRCP
Consultant Dermatologist
Honorary Professor of Dermatology
University College London
Chelsea & Westminster Hospitals
London
UK
Divulgaciones
CBB is the owner and CEO of Bruce Shrink Ltd., the publisher of Male Genital Skin Disease, an e-book authored by CBB. He has done consultancy work for the British Skin Foundation. The fee for this work is usually paid to the British Skin Foundation. He is the honorary secretary of the British Skin Foundation, the senior Medical Trustee. CBB has provided advice to MC2, with a pipeline lichens sclerosis product, for which he has not received payment. CBB does a dedicated weekly male genital clinic at University College London Hospitals from which his employer receives income. CBB has a private practice and patients with male genital skin disorders consult him, for which he is remunerated. CBB is a frequent speaker at meetings on male genital dermatology (occasionally, his travel and accommodation are subsidised and he received honoraria) and is in receipt of a grant from a private donor, administered by the British Skin Foundation, to investigate the relationship of lichen sclerosus to penis cancer. He has been appointed to lead the 2024 reiterate of the British Association of Dermatology Guidelines on lichen sclerosus; he has previously been contributor. Occasionally, CBB provides expert advice medical litigation, for which he receives remuneration. He is an author of a number of references cited in this topic.
Revisores por pares
Jesse Mills, MD
Professor of Urology
Director of the Men's Clinic at UCLA
University of California Los Angeles
Los Angeles
CA
Divulgaciones
JM declares that he has no competing interests.
Colm O'Mahony, MD, FRCP, BSc, DIPVen
Consultant in Sexual Health
Department of Sexual Health
Countess of Chester Hospital NHS Foundation Trust
Chester
UK
Divulgaciones
CO declares that he has no competing interests.
Sarah Edwards, MD
Consultant
Department of GU Medicine
West Suffolk Hospital
Suffolk
UK
Divulgaciones
SE declares that she has no competing interests.
David Paige, MD
Consultant Dermatologist and Honorary Senior Lecturer
Dermatology Department
The Royal London Hospital
London
UK
Divulgaciones
DP declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Edwards SK, Bunker CB, van der Snoek EM, et al. 2022 European guideline for the management of balanoposthitis. J Eur Acad Dermatol Venereol. 2023 Jun;37(6):1104-17.Texto completo Resumen
Bunker CB, Watchorn RE. Dermatoses of the male genitalia. In: Griffiths C, Barker J, Bleiker T, et al. Rook's textbook of dermatology. 10th ed. Oxford: Wiley; 2024 (in press).
Lewis FM, Tatnall FM, Velangi SS, et al. British Association of Dermatologists guidelines for the management of lichen sclerosus 2018. Br J Dermatol. 2018;178:839-53.Texto completo
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Eczema e dermatite
- Dermatite atópica
- Dermatite seborreica
Más DiferencialesGuías de práctica clínica
- European guideline for the management of balanoposthitis
- Sexually transmitted infections treatment guidelines
Más Guías de práctica clínica
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