Genital skin lesions

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

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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