The usefulness of a diagnostic biopsy clinic in a genitourinary medicine setting: Recent experience and a review of the literature

I. Palamaras, M. Hamill, G. Sethi, D. Wilkinson, H. Lamba

Research output: Contribution to journalReview article

Abstract

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.

Original languageEnglish (US)
Pages (from-to)905-910
Number of pages6
JournalJournal of the European Academy of Dermatology and Venereology
Volume20
Issue number8
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

Keywords

  • Biopsy
  • Genital dermatoses
  • Penile dermatoses

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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