Clinical and dermoscopic profile of non-venereal genital dermatoses and its impact on the quality of life: A cross-sectional study of 550 cases.

Abstract

Background Non-venereal genital dermatoses cover a broad spectrum of conditions with varying aetiologies and can be confused with venereal disorders. This may cause significant anxiety to the patient as well as diagnostic difficulties for the clinician. Objective The purpose was to study the clinico-epidemiological pattern of non-venereal genital dermatoses along with their dermoscopic features and to assess their impact on the quality of life. Methods This was a prospective, cross-sectional, observational study of 503 consecutive adult patients with non-venereal genital dermatoses. Relevant history and clinical examination, dermoscopy findings were documented and histopathology was performed where indicated. Statistical analyses was done using SPSS software v.23. Results Five hundred and three individuals with non-venereal genital lesions were enrolled. Some patients had multiple dermatoses, so a total of 550 cases were analysed. Men outnumbered women (5.8:1). A total of 49 different non-venereal genital dermatoses were identified. The most common ones were scabies 97 (17.6%), vitiligo 54 (9.8%), lichen simplex chronicus 43 (7.8%), lichen sclerosus 43 (7.8%) and lichen planus 39 (7.1%). Other dermatoses included psoriasis, Zoon's balanitis, lichen nitidus, angiokeratoma and idiopathic scrotal calcinosis. Physiological conditions were noted in 56 (10.2%) cases, while 5 (1%) cases were premalignant and malignant disorders. The commonest symptom was genital pruritus 337 (60.9%). Scrotum was most frequently affected site in men (54.6%) and labia majora in women (81.6%). Comparative analysis between the dermoscopic features of similar-looking disorders like vitiligo versus lichen sclerosus, scrotal dermatitis versus psoriasis and lichen planus versus psoriasis was statistically significant (p<0.05). There was a large effect on the quality of life in 8(1.5%), moderate effect in 87(16.2%) and small effect in 385 (71.8%) patients. Dermatology life quality index was significantly elevated in women. Seventy six (15.1%) patients suffered from venerophobia. Limitations Because of the cross-sectional study design, dermatoscopic examinations were performed at various phases of the diseases. Histopathology was performed in a limited number of cases, so findings on dermoscopy and histopathology could not be correlated. Conclusion Non-venereal genital dermatoses are common and more so among men. The most common dermatoses noted was scabies followed by vitiligo and lichen simplex chronicus. The present study provides detailed clinical and dermoscopy features in Indian patients. Dermoscopy is a useful tool in the diagnosis of these diseases. These dermatoses have mild to moderate effects on patients' quality of life; some of these patients suffer from venereophobia. Recognising and treating this issue will aid in properly managing these patients.