Non-venereal genital dermatoses and their impact on quality of life-A cross-sectional study

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

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.

An Observational Study on Female Genital Dermatoses and the Impact of Chronic Genital Dermatoses on Quality of Life in Adult Females

Background

Female genital dermatoses (FGD) or vulvar dermatoses are a group of disorders that affect the vulva and contiguous parts. Most of the FGDs can be chronic or recurrent. Effects on Quality of life (QoL) in patients having dermatological conditions are well studied but this is not the case in vulvar dermatoses.

Aims

We aimed to study the etiology of genital dermatoses in females attending the Dermatology Out Patient Department (OPD) and to assess QoL in females with chronic FGD (>6 weeks duration).

Settings and Design

This was an observational study on female patients with vulvar complaints presenting to dermatology OPD. Both venereal and nonvenereal dermatoses were enrolled. QoL was assessed in females with chronic FGD using a self-administered Dermatological Life Quality Index (DLQI) questionnaire.

Statistical Analysis

Sample size was calculated using the formula Categorical variables were presented as numbers and percentages (%) and continuous variables were presented as mean ± standard deviation (SD) and median. The normality of the data was tested by the Kolmogorov-Smirnov test or non-parametric test. A t-test was used for the estimation of the mean.

Results

Ninety-seven patients were included in our study; Vulvovaginal candidiasis was the most common dermatoses (22.6%); Lichen simplex chronicus (11.3%) the commonest non-venereal dermatoses. 57 (58.7%) had chronic FGD, among whom 43 (75.4%) had significant QoL impairment.

Conclusions

Infectious etiologies predominated. There was significant impairment in QoL in females with chronic FGD.

The performance of an artificial intelligence-based computer vision mobile application for the image diagnosis of genital dermatoses: a prospective cross-sectional study

BACKGROUND

There is a huge demand-supply gap between the incidence of genital dermatoses (including sexually transmitted infections and non-venereal genital dermatoses) and physicians trained to manage them.

OBJECTIVES

To find out the performance of an artificial intelligence (AI)-based mobile application in the image diagnosis of genital dermatoses, and to compare it with primary care physicians (PCPs) and dermatologists.

METHODS

Photos of the genital diseases of consecutive patients presenting to the STD and genital diseases clinic were included. The gold standard diagnosis was established by the consensus of two certified dermatologists after examination and one positive investigation. Image diagnoses by the DermaAId application, two PCPs, and two dermatologists were recorded and compared to the gold standard diagnosis and to each other.

RESULTS

A total of 257 genital disease images, including 95 (37.0%) anogenital warts, 60 (22.2%) lichen sclerosus, 20 (7.8%) anogenital herpes, 15 (5.8%) tinea cruris, 14 (5.4%) molluscum contagiosum, 9 (3.5%) candidiasis, 8 (3.1%) scabies, 6 (2.3%) squamous cell carcinomas, were included. The top-1 correct diagnosis rate of the application was 68.9%, compared to the 50.4% of the PCPs and 73.2% of the dermatologists. The application significantly outperformed PCPs with regard to the correlation with the gold standard diagnosis (P < 0.0001), and matched that of the dermatologists.

CONCLUSIONS

AI-based image diagnosis platforms can potentially be a low-cost rapid decision support tool for PCPs, integrated with syndromic management programs and direct-to-consumer services, and address healthcare inequities in managing genital dermatoses.

The Role and Impact of Artificial Intelligence in Addressing Sexually Transmitted Infections, Nonvenereal Genital Diseases, Sexual Health, and Wellness

The potential of artificial intelligence (AI) in diagnosing and managing sexually transmitted infections (STIs), nonvenereal genital diseases, and overall sexual health is immense. AI shows promise in STI screening and diagnosis through image recognition and patient data analysis, potentially increasing diagnostic accuracy while ensuring inclusivity. AI can fuel the transformation of e-health and direct-to-consumer services, enhancing targeted screening and personalized interventions while improving the user-friendliness of services. There is a significant role for AI in sexual education, particularly its use in interactive, empathetic chatbots. AI's integration into health care as a decision support tool for primary health-care providers can boost real-time diagnostic accuracy. Furthermore, AI's use in big data can enhance real-time epidemiology, predictive analysis, and directed interventions at population levels. However, challenges such as real-world diagnostic accuracy, liability, privacy concerns, and ethical dilemmas persist. Future directions include an emphasis on inclusivity, language accommodation, and swift research-to-practice transitions. Collaboration among policymakers, researchers, and health-care providers is needed to leverage AI's transformative potential in sexual health.

Quality of life measurement in vitiligo. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes with external experts

Members of the European Academy of Dermatology and Venereology (EADV) Task Force on Quality of Life (QoL) and Patient Oriented Outcomes reviewed the instruments available for health-related (HR) QoL assessment in vitiligo and together with external vitiligo experts (including representatives of the EADV Vitiligo Task Force) have made practical recommendations concerning the assessment of QoL in vitiligo patients. The Dermatology Life Quality Index (DLQI) was the most frequently used HRQoL instrument, making comparison of results between different countries possible. Several vitiligo-specific instruments were identified. The vitiligo Impact Scale (VIS) is an extensively validated vitiligo-specific HRQoL instrument with proposed minimal important change and clinical interpretation for VIS-22 scores. VIS-22 was developed for use in India, where there are some specific cultural beliefs concerning vitiligo. The EADV Task Force on QoL and Patient Oriented Outcomes recommends use of the DLQI and the Children's Dermatology Life Quality Index (CDLQI) as dermatology-specific instruments in vitiligo. There is a strong need for a valid (including cross-cultural validation) vitiligo-specific instrument that can be either a new instrument or the improvement of existing instruments. This validation must include the proof of responsiveness.