Genital Itch/Rash in Men

History and Examination

• Ask about onset/duration, site, timing (e.g. intermittent vs constant; postcoital), other features
• Ask about itch, pain, discharge (non-urethral: for urethral discharge see here); erythema (redness); scale; sweat;
• Ask about possible triggers e.g. change of soap
• Ask about continence and ask about hygiene
• Take a full sexual history
• Examine the affected regions

 

Causes

• Some causes are listed in the table
• Other causes (included in the dermatoses group) include
  • Lichen simplex (dermatitis due to localised itch-scratch response resulting in thickened skin on the scrotum
  • Atopic dermatitis
  • Seborrhoeic dermatitis (clue is scalp involvement)
  • Irritant contact dermatitis (common in incontinent patients; also seen with vigorous cleansing; most common cause of non-specific balanitis)
  • Intertrigo (skin fold dermatitis)
  • Allergic contact dermatitis
• Another common cause is tinea cruris (or ‘jock itch’)- fungal infection which appears classically as erythematous with central clearing and a raised edge.  Treatment is with an antifungal cream e.g. clotrimazole or terbinagine

Advertisement