Thursday, November 30, 2023
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Medical Director
Mindful Dermatology
Dallas, Texas
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This activity is intended for dermatologists, rheumatologists, primary care physicians, nurses, nurse practitioners, and physician assistants.
The goal of this activity is to increase awareness of the burden of genital psoriasis in patients and to consider patients' treatment goals when deciding on a treatment plan.
Upon completion of this activity, participants will:
As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.
Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.
Medical Director
Mindful Dermatology
Dallas, Texas
Medscape, LLC staff have disclosed that they have no relevant financial relationships.
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
Developed through a partnership between Medscape and the National Psoriasis Foundation.
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CME / ABIM MOC / CE Released: 8/20/2020
Valid for credit through: 8/20/2021, 11:59 PM EST
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Four years ago, Alex Patrick, age 27, was diagnosed with mild to moderate psoriasis affecting his knees, elbows, and scalp. His dermatologist prescribed a topical corticosteroid for flare-ups. The severity and BSA of his psoriasis stayed relatively stable until 3 months ago, when Alex noticed red patches on his genitals. The lesions continued to worsen and Alex made a telemedicine appointment with his dermatologist.
Alex: Hi Dr Cora.
Dr Cora: Hello, Alex. Nice to see you again. How have you been?
Alex: Ok...except for this new "problem" I'm having. And the pandemic, of course.
Dr Cora: Yes, we're all trying to manage as best as we can. (glances at computer screen) So, you have some red lesions in your genital area.
Alex: Um...yeah.
Dr Cora: On your penis? Your scrotum?
Alex: (a bit embarrassed) Um...yeah...both. And a little bit on my upper thighs.
Dr Cora: About when did you notice these lesions?
Alex: Um...about 3 months ago. I thought it was just irritation from cycling but it wouldn't go away.
Dr Cora: (glances at chart) And you saw your primary care physician about it?
Alex: Yeah, a couple of months ago. He thought it was just jock itch and prescribed some kind of cream. It didn't help.
Dr Cora: Can you describe what the lesions look like?
Alex: Well, they're like...um...a bunch of red patches.
Dr Cora: Do they itch?
Alex: Oh yeah, they itch a lot. And they kind of sting.
Dr Cora: Are they scaly?
Alex: No, not really. They're just red. And a little crusted over where I've scratched too much.
Dr Cora: Is there anything in particular that makes it feel worse?
Alex: Yeah, it gets irritated when anything rubs against the area. I bike a lot, you know. And go to spin classes. That definitely makes it worse. Do you think it's some kind of STD? I did have...um...sex with someone recently.
Dr Cora: It's possible but it sounds more like it may be your psoriasis. I would have to see to be sure, but that would be my guess.
Alex: Really? Down there?
Dr Cora: Yes, the genitals can be affected by psoriasis.
Alex: Hmm. The lesions don't really look the same as the ones on my elbows and knees. They're not as... um... scaly? And they sting more.
Dr Cora: Well, the genital area has more moisture, which can reduce the scaling. Also, the skin there is thinner and more tender than your elbows and knees. I can't be sure about this unless I see the lesions. Would you mind sending me a photo of the lesions?
Alex: (slightly taken aback) Um...ok...I guess...yeah, alright.
Dr Cora: I completely understand your hesitation, but I'll be better able to help you once I can see the lesions and confirm the cause. Send me a photo and we'll talk again later today after I have a look at it.
Alex: Ok.
Dr Cora: Okay, if you can send it to this email address...
