Skin conditions of the male genitalia

Non-sexually acquired male genital dermatoses occur most commonly in the uncircumcised. They can cause psychological morbidity and sexual dysfunction, amounting to male dyspareunia. Some, such as lichen sclerosus, have a significant precancerous potential. Diagnosis depends on accurate history taking, systematic examination of the anogenital area (and often the extragenital skin) and investigations to exclude diabetes, sexually transmitted infections and cancer. Some patients require a biopsy. Specific management depends on the clinicopathological diagnosis. General and non-specific interventions include avoidance of contact with soap and urine, and the use of soap substitutes and moisturizers. Many people with genital skin problems ‘overwash’, compounding the problem and creating irritant contact dermatitis. Failure of maximal conventional medical management usually necessitates the surgical intervention of circumcision.