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

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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
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