PSD01 Clinical patterns and treatment outcomes of male genital dermatoses: experience in a UK specialist dermatology service

Abstract Male genital dermatoses are common and can cause considerable morbidity. Despite their prevalence, real-world data on clinical patterns and treatment outcomes remain limited. Understanding these aspects is essential for optimizing patient care and service provision. Our objective was to analyse the clinical presentations, disease patterns and treatment outcomes of male genital dermatoses in a specialist dermatology clinic setting. This retrospective cohort study analysed data from 852 consecutive male patients presenting with nonvenereal genital symptoms who attended a specialist male genital dermatology clinic in the UK under the care of a single consultant. Data collected included presenting symptoms, clinical diagnoses, symptom duration, circumcision, smoking status and treatment outcomes. Descriptive statistics were used to summarize patient characteristics, and χ2-tests were performed to evaluate associations between smoking status, disease prevalence and treatment outcomes. The cohort’s mean age was 45.9 years (range 3–91), with peak incidence between age 30 and 59 years (55.3%). Most patients (74.5%) were uncircumcised. The primary presenting symptoms were genital rash (38.3%), pain, soreness or burning (20.4%), lesions (19.4%) and foreskin problems (11.2%). Male genital lichen sclerosus was the most common diagnosis (40.8%) and was significantly more prevalent in uncircumcised men (43.9% vs. 28.1% in circumcised men). Other common diagnoses included various forms of balanitis (12.8%), dermatitis (10.7%), lichen planus (6.5%) and psoriasis (6.0%). While inflammatory conditions such as lichen planus and psoriasis were more common in younger adults, balanitis and premalignant conditions predominantly affected older patients. Psoriasis was more prevalent in people who formerly or currently smoked compared with those who had never smoked (11.6% vs. 5.0%, χ2 = 7.82, P = 0.005). Lichen sclerosus showed a trend towards poorer treatment outcomes in those who currently smoked compared with those who had never smoked (34.4% vs. 51.1% success rate, χ2 = 3.14, P = 0.07). The mean duration of symptoms before specialist consultation was 37.2 months. Treatment outcomes were favourable overall, with 44.2% (n = 377) achieving cure or remission and 9.5% (n = 81) showing improvement. Surgical intervention or specialist referral was required in 12.7% (n = 108) of cases, including circumcision (6.2%, n = 53), further surgery (4.1%, n = 35) and referral to other specialties (2.3%, n = 20). This large-scaled study demonstrates distinct patterns in the presentation and management of male genital dermatoses. The significant delays in presentation, high prevalence of lichen sclerosus (particularly in uncircumcised men) and varying treatment responses emphasize the need for earlier specialist referral and management strategies tailored to individual risk factors. These findings support the value of specialist clinics in managing these conditions and will aid in service optimization.