Imiquimod 5%cream,an immune response modifier licensed for treatment of external ano-genital warts and superficial basal cell carcinomata,is known to cause local erythema,oedema and,rarely,exacerbation of psoriasis.We...Imiquimod 5%cream,an immune response modifier licensed for treatment of external ano-genital warts and superficial basal cell carcinomata,is known to cause local erythema,oedema and,rarely,exacerbation of psoriasis.We describe a case of exacerbation of eczema following application of this cream in a man with penile warts.展开更多
Genital diseases include a wide range of lesions e.g. infectious and inflammatory. In most cases a clinical diagnosis is reached without the need for a biopsy. Nonetheless, a genital biopsy is safe and may help to con...Genital diseases include a wide range of lesions e.g. infectious and inflammatory. In most cases a clinical diagnosis is reached without the need for a biopsy. Nonetheless, a genital biopsy is safe and may help to confirm the diagnosis. We established a dedicated diagnostic biopsy clinic in 2003. Our objective was to evaluate the effectiveness of our diagnostic biopsy clinic and compare it with other Genitourinary medicine (GUM) clinics in the UK. A retrospective case-note study was performed on 71 patients referred to the biopsy clinic with persistent genital lesions over a 12-month period. Forty-seven biopsies were performed (71%biopsy rate). 43 specimens (92%) were appropriate for histopathological diagnosis. Of these 15%were lichen planus, 15%lichen sclerosis, 10%psoriasis, 7.5%each: eczema, Zoon’s and non-specific balanitis. The remainder represented a variety of other conditions. In 27 cases (68%) the clinical diagnosis was consistent with the histological result. The possibility of self-referral and walk-in nature of our GUM service substantially decrease the waiting times for assessment of anogenital disorders. We had a lower biopsy rate for the diagnosis of non-specific balanitis (7.5%) compared with the average rate (21.5%) in 14 UK GUM clinics and good agreement between clinical and histological diagnosis. An empirical first treatment, with simple emollients before biopsy, appears to be a safe clinical approach for the treatment of non-specific balanitis. A multidisciplinary approach (GUM physicians, dermatologists and urologists/gynaecologists) could help prevent unnecessary biopsies and improve correlation between clinical and histological diagnosis.展开更多
文摘Imiquimod 5%cream,an immune response modifier licensed for treatment of external ano-genital warts and superficial basal cell carcinomata,is known to cause local erythema,oedema and,rarely,exacerbation of psoriasis.We describe a case of exacerbation of eczema following application of this cream in a man with penile warts.
文摘Genital diseases include a wide range of lesions e.g. infectious and inflammatory. In most cases a clinical diagnosis is reached without the need for a biopsy. Nonetheless, a genital biopsy is safe and may help to confirm the diagnosis. We established a dedicated diagnostic biopsy clinic in 2003. Our objective was to evaluate the effectiveness of our diagnostic biopsy clinic and compare it with other Genitourinary medicine (GUM) clinics in the UK. A retrospective case-note study was performed on 71 patients referred to the biopsy clinic with persistent genital lesions over a 12-month period. Forty-seven biopsies were performed (71%biopsy rate). 43 specimens (92%) were appropriate for histopathological diagnosis. Of these 15%were lichen planus, 15%lichen sclerosis, 10%psoriasis, 7.5%each: eczema, Zoon’s and non-specific balanitis. The remainder represented a variety of other conditions. In 27 cases (68%) the clinical diagnosis was consistent with the histological result. The possibility of self-referral and walk-in nature of our GUM service substantially decrease the waiting times for assessment of anogenital disorders. We had a lower biopsy rate for the diagnosis of non-specific balanitis (7.5%) compared with the average rate (21.5%) in 14 UK GUM clinics and good agreement between clinical and histological diagnosis. An empirical first treatment, with simple emollients before biopsy, appears to be a safe clinical approach for the treatment of non-specific balanitis. A multidisciplinary approach (GUM physicians, dermatologists and urologists/gynaecologists) could help prevent unnecessary biopsies and improve correlation between clinical and histological diagnosis.
