Atlas of Male Genital Disorders Giuseppe Micali • Marco Cusini • Pompeo Donofrio • Franco Dinotta Atlas of Male Genital Disorders A Useful Aid for Clinical Diagnosis 123 Giuseppe MicaliDermatology Unit, Dipartimento di Specialità Medico-Chirurgiche, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Marco Cusini Center for Sexually Transmitted Diseases, Dermatology Unit, Dipartimento di Anestesiologia, Terapia Intensiva e Scienze Dermatologiche, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy Pompeo Donofrio School of Dermatology and Venereology, “Federico II” University of Naples, Naples, Italy Franco DinottaCenter for Sexually Transmitted Diseases, Dermatology Unit, Dipartimento di Specialità Medico- Chirurgiche, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy ISBN 978-88-470-2786-2 ISBN 978-88-470-2787-9(eBook) DOI 10.1007/978-88-470-2787-9 Springer Milan Dordrecht Heidelberg London New York Library of Congress Control Number: 2012951967 © Springer-Verlag Italia 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by si- milar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must al- ways be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefo- re free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. 9 8 7 6 5 4 3 2 1 2012 2013 2014 2015 Cover design:Ikona S.r.l., Milan, Italy Typesetting: Ikona S.r.l., Milan, Italy Springer-Verlag Italia S.r.l., Via Decembrio 28, I-20137 Milan Springer is a part of Springer Science+Business Media (www.springer.com) Preface Male genital disorders encompass many aspects of gender medicine, includ- ing sexually transmitted infections and penile cancer. Since its inception as a specialty, dermatology has focused so prominently on genital disorders that many dermatology societies and units bear the names “dermatovenereology” or “dermatology and venereology”. Professors Giuseppe Micali (Catania), Marco Cusini (Milan), Pompeo Donofrio (Naples), and Franco Dinotta (Catania) are well suited to act as learned authorities on genital disorders, as is clear from this skillfully crafted and extraordinarily useful compendium, the Atlas of Male Genital Disorders. All four of these distinguished physician-sci- entists have worked on genital disorders for many years. Each has actively par- ticipated in many scientific meetings on the subject and published papers in national and international journals. They run dedicated clinics on genital dis- orders at the Departments of Dermatology of the Universities of Milan, Naples, and Catania. The clinic in Catania is headed by the esteemed Professor Giuseppe Micali, an internationally acclaimed authority on penile lichen planus, penile cancer, and much more. The editors and authors of this stellar work well deserve accolades as they have advanced and disseminated knowledge in this vital area of gender med- icine. This erudite book merits the attention of practicing physicians world- wide, who will without doubt benefit from reading it. October 2012 Robert A. Schwartz V Contents 1 Anatomy of Male Genitalia............................................................. 1 Franco Dinotta, Maria Rita Nasca, and Giuseppe Micali 2 Infections.......................................................................................... 5 Marco Cusini, Stefano Ramoni, Salvatore Ferraro, and Franco Dinotta Viral Infections Genital Warts............................................................................. 6 Molluscum Contagiosum........................................................... 10 Herpes Simplex.......................................................................... 12 Herpes Zoster............................................................................. 14 Bacterial Infections Erythrasma................................................................................. 16 Acute Bacterial Balanoposthitis................................................ 18 Fournier’s Gangrene.................................................................. 20 Fungal Infections Candidiasis................................................................................. 22 Tinea Cruris............................................................................... 24 3 Infestations....................................................................................... 27 Marco Cusini, Francesco Lacarrubba, Stefano Ramoni, and Franco Dinotta Pubic Lice.......................................................................................... 28 Scabies ............................................................................................ 30 Larva Migrans.................................................................................... 32 Tick Bites........................................................................................... 34 4 Sexually Transmitted Diseases........................................................ 37 Franco Dinotta, Stefano Ramoni, Pompeo Donofrio, and Marco Cusini Syphilis ......................................................................................................... 38 VII VIII Contents Granuloma Inguinale......................................................................... 41 Lymphogranuloma Venereum............................................................ 42 Chancroid........................................................................................... 44 Gonorrhea.......................................................................................... 46 Nongonococcal Urethritis.................................................................. 48 5 Inflammatory Disorders.................................................................. 51 Maria Rita Nasca, Francesco Lacarrubba, Maria Letizia Musumeci, and Giuseppe Micali Eczematous Disorders Contact Dermatitis (Irritant/Allergic)........................................ 52 Atopic Dermatitis....................................................................... 54 Seborrheic Dermatitis................................................................ 56 Lichen Simplex (Neurodermatitis)............................................ 58 Erythemato-Squamous and Papular Disorders Psoriasis..................................................................................... 60 Pityriasis Rosea (Gibert)............................................................ 62 Circinate Reactive Balanitis (Reiter’s Disease)......................... 64 Lichen Planus............................................................................. 66 Pyogenic Granuloma................................................................. 68 Sclerosing Lymphangitis........................................................... 70 Hidradenitis Suppurativa (Verneuil’s Disease).......................... 72 Vescico-Bullous Disorders Erythema Multiforme................................................................ 74 Fixed Drug Eruption.................................................................. 76 Pemphigus Vulgaris................................................................... 78 Dermatitis Herpetiformis (Dühring’s Disease).......................... 80 Bullous Pemphigoid................................................................... 82 Hailey-Hailey Disease............................................................... 84 Ulcerative and Granulomatous Disorders Aphthous Ulcers........................................................................ 86 Behçet’s Disease........................................................................ 88 Pyoderma Gangrenosum............................................................ 90 Crohn’s Disease......................................................................... 91 Other Inflammatory Disorders Lichen Sclerosus........................................................................ 92 Plasma Cell Balanitis (Zoon)..................................................... 94 Angioedema............................................................................... 96 6 Pigmentation Disorders................................................................... 99 Pompeo Donofrio, Paola Donofrio, Maria Grazia Francia, and Giuseppe Micali Vitiligo...............................................................................................100 Acanthosis Nigricans.........................................................................102 Contents IX Melanosis...........................................................................................104 Melanocytic Nevi...............................................................................106 7 Benign Neoplastic Disorders...........................................................109 Pompeo Donofrio, Paola Donofrio, Piera Catalfo, and Giuseppe Micali Soft Tissue Tumors Pearly Penile Papules.................................................................110 Fibroepithelial Polyp.................................................................112 Angiokeratoma..........................................................................114 Lymphangiomas.........................................................................116 Epithelial Tumors Seborrheic Keratosis..................................................................118 Penile Horn................................................................................120 Pseudoepitheliomatous Keratotic and Micaceous Balanitis......122 Leukoplakia...............................................................................124 8 Malignant Neoplastic Disorders.....................................................127 Giuseppe Micali, Francesco Lacarrubba, Philip J. Cohen, and Robert A. Schwartz Soft Tissue Tumors Kaposi’s Sarcoma......................................................................128 Angiosarcoma............................................................................130 Epithelial Tumors In Situ Carcinomas....................................................................132 Extramammary Paget’s Disease .........................................132 Bowenoid Papulosis............................................................134 Erythroplasia of Queyrat.....................................................136 Bowen’s Disease.................................................................138 Invasive Carcinomas.................................................................140 Basal Cell Carcinoma.........................................................140 Squamous Cell Carcinoma .................................................142 Verrucous Carcinoma..........................................................146 Melanocytic Tumors Melanoma..................................................................................148 Other Tumors Cutaneous Metastatic Disease...................................................150 9 Dysembrioplastic Disorders............................................................153 Pompeo Donofrio, Paola Donofrio, Maria Grazia Francia, and Maria Rita Nasca Fordyce’s Spots..................................................................................154 Sebaceous Hyperplasia......................................................................156 X Contents Median Raphe Cysts..........................................................................158 Epidermoid Cysts..............................................................................160 Hypospadia........................................................................................162 10 Miscellaneous Disorders..................................................................165 Marco Cusini, Stefano Ramoni, Anna Elisa Verzì, and Franco Dinotta Phimosis (Acquired)..........................................................................166 Paraphimosis......................................................................................168 Synechiae...........................................................................................170 Phlebectasia ......................................................................................172 Induratio Penis Plastica ....................................................................174 Traumatic and Self-Induced Lesions ................................................176 Tattoos................................................................................................178 Smegmoliths......................................................................................180 Contributors Piera Catalfo Dermatology Unit, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Philip J. CohenDepartment of Dermatology, UMDNJ - New Jersey Medical School, Newark, NJ, USA Marco Cusini Center for Sexually Transmitted Diseases, Dermatology Unit, Dipartimento di Anestesiologia, Terapia Intensiva e Scienze Dermatologiche, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy Franco DinottaCenter for Sexually Transmitted Diseases, Dermatology Unit, Dipartimento di Specialità Medico-Chirurgiche, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Paola Donofrio Dermatology and Venereology, “Federico II” University of Naples, Naples, Italy Pompeo Donofrio School of Dermatology and Venereology, “Federico II” University of Naples, Naples, Italy Salvatore Ferraro Dermatology Unit, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Maria Grazia Francia Dermatology and Venereology, “Federico II” University of Naples, Naples, Italy Francesco Lacarrubba Dermatology Unit, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Giuseppe Micali Dermatology Unit, Dipartimento di Specialità Medico- Chirurgiche, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Maria Letizia Musumeci Dermatology Unit, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy XI XII Contributors Maria Rita Nasca Dermatology Unit, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy Stefano Ramoni Center for Sexually Transmitted Diseases, Dermatology Unit, Dipartimento di Anestesiologia, Terapia Intensiva e Scienze Dermatologiche, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy Robert A. Schwartz Department of Dermatology, UMDNJ - New Jersey Medical School, Newark, NJ, USA Anna Elisa Verzì Dermatology Unit, AOU “Policlinico-Vittorio Emanuele”, Presidio “G. Rodolico”, Catania, Italy