A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing) of the skin and mucous membranes.
- Genitoanal area (90% of cases) [white, porcelain-like patches; vulnerable skin; frequently bleeding rhagades (fissures; narrow, cleft-like tear that cuts through all layers of the epidermis) with tendency to superinfection (bacterial or mycotic (“caused by fungi”) infections)
- Woman (atrophy (“regression”) of the vulva (entirety of the external primary sex organs); varying degrees of severity in the late stages:
- Atrophy of the small and subsequently the large labia (labia majora), in the further late stage:
- Findings of Kraurosis vulvae (synonyms: Craurosis vulvae, vulvar dystrophy), i.e. degenerative change of the skin, accompanied by atrophy and hyperplasia (“excessive cell formation”). This leads to shrinkage of the vulva with subsequent sclerosis (tissue hardening) of the subcutaneous fatty tissue; stenosis (narrowing) of the introitus vaginae (vaginal entrance), anus, urethra (urethra); disappearance of the clitoris (“burried clitoris”)]
- Male [white, hardened patches on the praeputium (foreskin); chronic balanitis (inflammation of the glans); soreness on the glans and foreskin; retraction of the foreskin is difficult (phimosis; foreskin constriction); in the late stages:
- Image of balanitis xerotica obliterans (BXO) – manifestation at the glans penis (glans) with meatus stenosis (narrowing of the urethral orifice) or constriction of the navicular fossa (ampullary dilation of the male urethra (urethra) located in the area of the glans penis just before the external urethral orifice)]
- Woman (atrophy (“regression”) of the vulva (entirety of the external primary sex organs); varying degrees of severity in the late stages:
- Extragenital area (10% of cases) [often affected mainly the lateral part of the neck, the skin of the neck, clavicle region, shoulders, presternal (the sternum region), mammary / breast and submammary / lower breast, flexor sides of the lower lame and inner thighs; in rare cases, also the oral mucosa; small (0.1 -3 cm) white – to bluish-white – roundish, slightly sunken spots to confluent areas and plaques with slight wrinkling of the skin, showing a “ridge-free”, smooth, parchment-like surface when illuminated laterally]
- Genitoanal area (90% of cases) [white, porcelain-like patches; vulnerable skin; frequently bleeding rhagades (fissures; narrow, cleft-like tear that cuts through all layers of the epidermis) with tendency to superinfection (bacterial or mycotic (“caused by fungi”) infections)
- Inspection (viewing) of the skin and mucous membranes.
- Cancer prevention
Square brackets [ ] indicate possible pathological (pathological) physical findings.
