II. Causes: Papulosquamous
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Psoriasis
- Red Plaques with overlying white or silver scale
- Isolated involvement of the genital skin without Plaques elsewhere would be rare
- Distinguish from Bowen Disease (or Penile Cancer in Situ)
- Responds to Topical Corticosteroids
- Pearly Penile Papules
- Small skin-colored, dome-shaped lesions form a ring at the base of the glans penis (at coronal sulcus)
- Asymptomatic
- Distinguish from Lichen Nitidus, Angiokeratomas
III. Causes: Inflammatory
-
Lichen Nitidus
- Tiny (1 mm), asymptomatic hypopigmented Papules
- Often found on non-genital skin
- Distinguish from Genital Herpes and pearly penile Papules
-
Lichen Planus
- Pruritic, sore, flat-topped polygonal violaceous Papules
- Often found on non-genital skin
- Distiniguish from Secondary Syphilis
- Responds to Topical Corticosteroids
-
Lichen Sclerosus of foreskin (Balanitis Xerotica Obliterans)
- Cellophane-like hypopigmented, thinned foreskin
- May result in Phimosis, Urinary Outflow Obstruction, painful Erections
- Pruritus and bleeding may also occur
- Distinguish from Scleroderma and Penile Cancer
- Responds to Topical Corticosteroids
IV. Causes: Vascular
V. Causes: Infectious
- Genital Herpes
- Genital Wart
- Scabies
- Syphilis (Primary Syphilis forms a painless Genital Ulcer or Chancre)
VI. Causes: Neoplastic
-
Penile Cancer in Situ (Bowen Disease)
- Plaque or penile ulcer most typically involving glans penis or foreskin
- Broad differential (e.g. Psoriasis, Lichen Sclerosus, Genital Herpes, Secondary Syphilis, Balanitis)
- Penile invasive squamous cell cancer
- Papulosquamous or exophytic lesions lesions on the penis
- Distinguish from condyloma