Abstract
It is a great pleasure to review this clinical guide written by a dermatologist and a genitourinary physician who have cooperated closely together in giving excellent service for the last 10 years in a district general hospital in the North of England. I have to admit bias and pride in being one of their trainers at one time. Outside the two specialties, diseases of the male genitalia, although common, receive little in the way of publicity. Patients may be seen in primary care, genitourinary medicine and dermatology or urology clinics, but there is little, if any, teaching of male genital disease in primary care. By working closely together, patient care can be improved immensely.
How is the book set out? It begins with a chapter on anatomy and normal variants, history taking and basic examination. It makes quite clear what is the province of both specialties and gives good guidance with some excellent photographs of variants. Then follows a section on hair and groin problems. It is worth reading for a beautiful description of folliculitis. There is a useful flow chart for the diagnosis of common problems in the male pubic area. The next chapter is on genital itching or rather that caused by arthropods, much more common than realized, with a useful way of diagnosing bites from mosquitoes, fleas and bedbugs as well all the other myriad causes. Problems with the foreskin cover all those diseases affecting it, with some excellent photographs of the conditions. This is followed by lumps and lesions, which are divided into benign and malignant conditions – and how to go about diagnosis again with some excellent clinical hints. If you don't know what the dimple sign for dermatofibroma is, refer to this work.
The red glans penis is followed by problems with pigmentation, a common clinical problem but so often mishandled. Next follows chapters on genital ulcers and blisters, penile discharge and dysuria and HIV and AIDS, not only its presentation but also skin diseases found with HIV infection. Later there is a chapter on common skin conditions affecting the genitals with conditions such as psoriasis and eczema excellently considered and illustrated. The last chapter, which owes a lot to the recent teaching of the Leeds School of Dermatology, is on psychological and psychiatric disorders – dysaesthesia syndromes, dermatitis artefacta, dysmorphophobia and delusions of parasitosis. There is a useful appendix of common dermatological terms, useful websites and addresses, partner notification, counselling and rates of sexually transmitted diseases in UK and USA since 1995.
The book is neatly presented. The photographs have been well produced. The advice is of first class. I am envious that I never had the chance while in NHS practice of writing such a worthwhile guide. But it is a book of great achievement, and for that, one gives praise and thanks and can also recommend it to a very wide group of health professionals.