Genital Dermatology Manual

Contents
Preface vii
1. Genital Anatomy ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 1
Libby Edwards
Female Genitalia 1
Male Genitalia 10
2. Terminology, Classification, and
Diagnosis of Genital Dermatological
Disorders? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 14
Peter J. Lynch
Terminology 14
Classification 19
Diagnosis 21
3. General Principles of Therapy ? ? ? ? ? ? 23
Peter J. Lynch
The Patient as a Person 23
4. Diagnostic and Therapeutic
Procedures ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 33
Libby Edwards
Diagnostic Procedures 33
Cytologic Smears 35
Cultures 40
Molecular Studies 41
Dermoscopy 41
Skin Biopsies 41
Therapeutic Procedures 47
Office Surgical Procedures 50
Conclusion 55
5. Red Disorders: Patches and
Plaques ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 56
Peter J. Lynch and Libby Edwards
Atopic Dermatitis and Lichen Simplex Chronicus 57
Irritant Contact Dermatitis 66
Allergic Contact Dermatitis 70
Seborrheic Dermatitis and Intertrigo 72
Psoriasis 75
Tinea Cruris (Jock Itch) 81
Erythrasma 83
Candidiasis 84
Perianal Bacterial Dermatitis (Also Called Perianal Infectious
Dermatitis, Perianal Streptococcal Dermatitis, Perianal
Streptococcal Cellulitis) 87
Lichen Planus 88
Pityriasis Rosea 91
Pityriasis (Tinea) Versicolor 92
Plasma Cell Mucositis (Plasma Cell Vulvitis and Balanitis, Zoon
Mucositis, Vulvitis Plasmacellularis, and Balanitis Circumscripta
Plasmacellularis) 92
Vestibulodynia (Vulvar Vestibulitis Syndrome, Vestibular Adenitis) 95
Red Scrotum Syndrome 96
Steroid Dermatitis (Steroid Addiction) 96
Extramammary Paget Disease 97
Squamous Cell Carcinoma In Situ/Squamous Intraepithelial
Neoplasia/Squamous Intraepithelial Lesion 99
High-Grade Squamous Intraepithelial Lesion 100
6. Red Disorders: Red Papules
and Nodules ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 105
Peter J. Lynch
Folliculitis 105
Keratosis Pilaris 105
Scabies 107
Miscellaneous Bites and Infestations 107
Cherry Angioma 108
Angiokeratoma 108
Hidradenitis Suppurativa (Acne Inversa) 110
Furunculosis (“Boils”) 115
Inflamed Cysts 116
Inflamed Bartholin Gland Cysts 117
Prurigo Nodularis (Picker Nodule) 117
Pyogenic Granuloma 119
Urethral Caruncle 120
Urethral Prolapse 120
Vulvar and Perineal Endometriosis 121
Hematoma 122
Hidradenoma Papilliferum (Mammarylike Gland Adenoma) 122
Nodular Scabies 122
Kaposi Sarcoma 123
Diaper Granulomas (Diaper Dermatitis of Jacquet, Granuloma
Gluteale Infantum) 124
7. Skin-Colored Disorders ? ? ? ? ? ? ? ? ? ? 129
Peter J. Lynch
Genital Warts 129
Clinical Presentation 129
Molluscum Contagiosum 135
Skin Tag (Acrochordon, Fibroepithelial Polyp) 138
Intradermal Nevi (Dermal Nevi) 139
Pearly Penile Papules 139
Vulvar Vestibular Papillomatosis 140
Fordyce Spots, Fordyce Granules, Tyson Glands, and Sebaceous
Gland Hyperplasia 141
Fox-Fordyce Disease (Apocrine Miliaria) 142x Contents
Lichen Nitidus 143
Hidradenoma Papilliferum (Mammarylike Gland Adenoma) 144
Neurofibroma 145
Condyloma Latum 145
Lymphogranuloma Venereum 147
Syringomas 147
Epidermal Cysts (Epidermoid Cysts) 148
Cysts of the Median Raphe 150
Mucinous Vestibular Cysts 150
Pilonidal Sinus (Pilonidal Cyst) 150
Bartholin Cysts and Abscesses 151
Lipoma 152
Sclerosing Lymphangitis and Mondor Thrombophlebitis of the
Penis 152
Squamous Cell Carcinoma of the Genitalia 153
Squamous Cell Carcinoma of the Male
Genitalia 153
Squamous Cell Carcinoma of the Genitalia in Women 156
Basal Cell Carcinoma 161
8. White Disorders ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 165
Libby Edwards
White Patches and Plaques 165
Procedures 179
White Papules and Nodules 187
9. Dark-Colored Lesions: Brown, Blue,
Gray, or Black Disorders ? ? ? ? ? ? ? ? ? 192
Peter J. Lynch
Physiological Hyperpigmentation 192
Acanthosis Nigricans 193
Postinflammatory Hyperpigmentation 194
Seborrheic Keratosis (pl: Seborrheic Keratoses) 195
Genital Varicosities 197
Genital Melanosis (Lentiginosis) 198
Melanocytic Nevus (“Mole,” Pigmented Nevus, pl: Nevi) 200
Melanoma 205
10. Blistering and Pustular Diseases ? ? ? 214
Libby Edwards
Blistering Infections 214
Noninfectious Blistering Eruptions 222
Pseudovesicular Conditions 239
True Pustular Diseases 241
Solid Lesions That Sometimes Appear Pustular 251
Vestibular Cysts 253
Other Diseases That Can Appear Yellow or Produce Crusting 253
11. Erosions and Ulcers? ? ? ? ? ? ? ? ? ? ? ? ? 258
Libby Edwards and Peter J. Lynch
Erosive Lichen Planus 258
Plasma Cell Balanitis and Vulvitis (Zoon Balanitis/Vulvitis) 268
Genital Skinfold Fissures 269
Mechanical Vulvar Fissures 270
Erosive Lichen Sclerosus (Lichen Sclerosus et Atrophicus,
Lichen Simplex Chronicus (Eczema, Atopic Dermatitis,
Neurodermatitis) 273
Contact Dermatitis 273
Fixed Drug Eruption 273
Necrolytic Migratory Erythema 273
Malignancies Presenting as Erosions 274
Infectious Ulcers 275
Syphilis 275
Chancroid 278
Genital Herpes in the Immunosuppressed 279
Granuloma Inguinale (Donovanosis) 281
Lymphogranuloma Venereum 283
Epstein-Barr Virus and Cytomegalovirus-Associated Ulcers 283
Noninfectious Ulcers 283
Genital Aphthous Ulcers and Complex Aphthosis (Synonyms:
Lipschütz Ulcer, Ulcus Vulvae Acutum, Reactive Nonsexually
Related Acute Genital Ulcers) 283
Aphthouslike Ulcers Associated With Infections 287
Behçet Disease 287
Crohn Disease 288
Pyoderma Gangrenosum 293
Ulcers Due to External Trauma 295
Deep Excoriation 296
Acknowledged Nonscratching, External Trauma 296
Unacknowledged External Trauma 297
Miscellaneous Ulcers 298
12. Edema? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 302
Peter J. Lynch and Libby Edwards
Acute Genital Edema (Angioedema) 302
Chronic Genital Edema (Elephantiasis) 304
13. Pruritus and Pain ? ? ? ? ? ? ? ? ? ? ? ? ? ? 310
Peter J. Lynch and Libby Edwards
Pruritus 310
Anogenital Pain 311
14. Vaginitis and Balanitis ? ? ? ? ? ? ? ? ? ? ? 325
Libby Edwards
Vaginitis 325
Balanitis 343
15. Special Issues in Genital
Dermatology ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? 350
Peter J. Lynch and Libby Edwards
Psychological Aspects 350
Genital Disease in Childhood 353
Immunosuppression 373
Transgender Issues 383
Geriatric Issues 385
Appendix A: Patient Handouts (English) 395
Appendix B (eBook only): Patient Handouts (Spanish)