Practical and highly illustrated, Genital Dermatology Manual, 4th Edition, by Drs. Libby Edwards and Peter J. Lynch, helps clinicians at all levels of experience arrive at an accurate diagnosis for both common and rare genital dermatologic lesions. More than 500 full-color photographs are arranged by appearance for rapid identification, offering superb visual guidance even for conditions not previously encountered. This easy-to-use reference is ideal for any clinician who sees men and women with disorders of the external genitalia, including dermatologists, gynecologists, urologists, primary care physicians, nurse practitioners, nurse midwives, and physician assistants. Arranges core chapters by disease presentation, such as patches and plaques, papules and nodules, and ulcers Includes variable morphologies, making it easier to arrive at a correct diagnosis even when encountering an atypical appearance of a common condition—for example, herpes simplex virus infection is discussed in chapters on blisters, erosions and ulcers, and special issues of immunosuppressed patients Updates include more clinical photographs throughout; an expanded therapy section including sinus tract un-roofing, vestibulectomy, lysis of adhesions and therapy of clitoral pseudocyst and phimosis; a new chapter on patient education; and new coverage of transgender and cosmetic issues Features chapters on special issues such as symptoms (itching and pain), immunosuppression, and pediatric, psychologic, and geriatric aspects of genital conditions Offers increased information on diagnostic and therapeutic procedures, as well as patient handouts suitable for copying and distribution
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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)
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