Male conditions
- Smegma: buildup of shed skin cells and sebum found under foreskin of uncircumcised men, improves with regular daily hygiene
- Fordyce spots: vascular ectasias, 1-2mm red/purple papules, can occasionally cause scrotal bleeding, can treat with laser therapy
- Pink pearly papules: whitish closely spaced papules usually seen around corona, seen in 14-48% men (more common if uncircumcised), unrelated to HPV, can treat with laser therapy, histologically angiofibromas
- Zoon balanitis: seen in uncircumcised men, papules/plaques on glans with shallow erosions, cured with circumcision or topical steroids
- Sclerosing lymphangitis: indurated/tender cord involving coronal sulcus and penile skin, usually associated with prior sexual trauma and resolves within weeks
- Median raphe cyst: seen on ventral portion of penis, do not communicate with urethra, treat with surgery
- Ectopic sebaceous glands: small flesh-colored papular lesions, pin sized, no treatment warranted
Non-gender specific
- Skin tag: usually asymptomatic but can become painful from trauma or torsion, seen in areas of friction, can excise, may be confused for fibrofolliculomas
- Epidermoid cysts: nonpainful, seen everywhere including scrotum, can rupture and cause painful inflammatory reaction, excise entire cyst wall to prevent recurrence, may require I&D if infected
- Seborrheic keratosis: lesions with stuck-on appearance, may drop off and spontaneously regrow, can treat with excision, abrupt increase in number can be associated with internal malignancy (Leser-Trelat sign)
- Lentigo simplex: brownish macules unrelated to sunlight, usually smaller than melanocytic nevi, biopsy if abnormal appearing
- Dermatofibroma: small hyperpigmented nodule, pinching causes downward movement (dimple sign), excision may result in cosmetic appearance that is postoperatively worse than preoperative appearance
- Neurofibroma: skin colored rubbery nodules, pressure causes invagination (button-holing), multiple may indicate Neurofibromatosis
- Capillary hemangioma: can occasionally cause bleeding or obstruction, majority involute with time, can treat with propranolol or topical timolol
- Melanocytic nevi: present as asymmetric pigmented macule/papule most commonly on glans, need careful differentiation with melanoma to prevent overtreatment
- Melanosis: usually occurs in younger patients (younger than melanoma age), no GI symptoms (differentiate from Peutz Jegher syndrome), biopsy required to rule out melanoma
References
- Link, R. and N. Tang. "Cutaneous Diseases of the External Genitalia." Campbell-Walsh Urology 12 (2020).