External Male Genitalia in Henoch-Schönlein Syndrome: A Systematic Review

The external genitalia are notoriously implicated in every fifth male with Henoch-Schönlein syndrome. Nonetheless, the underlying conditions are poorly categorized. To characterize the involvement of the external male genitalia in this vasculitis, we performed a systematic review of the literature....

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Main Authors: Valentina M. L. Montorfani-Janett (Author), Gabriele E. Montorfani (Author), Camilla Lavagno (Author), Gianluca Gualco (Author), Mario G. Bianchetti (Author), Gregorio P. Milani (Author), Sebastiano A. G. Lava (Author), Marirosa Cristallo Lacalamita (Author)
Format: Book
Published: MDPI AG, 2022-07-01T00:00:00Z.
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Summary:The external genitalia are notoriously implicated in every fifth male with Henoch-Schönlein syndrome. Nonetheless, the underlying conditions are poorly categorized. To characterize the involvement of the external male genitalia in this vasculitis, we performed a systematic review of the literature. For the final analysis, we selected 85 reports published between 1972 and 2022, which reported on 114 Henoch-Schönlein cases (≤ 18 years, N = 104) with a penile (N = 18), a scrotal (N = 77), or both a penile and a scrotal (N = 19) involvement. The genital involvement mostly appeared concurrently with or after the cutaneous features of Henoch-Schönlein syndrome, while it preceded the presentation of Henoch-Schönlein syndrome in 10 cases. Patients with penile involvement (N = 37) presented with swelling (N = 26), erythema (N = 23), and purpuric rash (N = 15). Most patients were otherwise asymptomatic except for transient micturition disorders (N = 2) or priapism (N = 2). Patients with scrotal involvement (N = 96) presented with pain (N = 85), swelling (N = 79), erythema (N = 42), or scrotal purpura (N = 22). The following scrotal structures were often involved: scrotal skin (N = 83), epididymis (N = 49), and testes (N = 39). An ischemic testicular damage was noted in nine patients (four with torsion and five without). The scrotal skin involvement was mostly bilateral, while that of the epididymis and testis were mostly (<i>p</i> < 0.0001) unilateral (with a significant predilection for the left side). In conclusion, this analysis allows for better categorization of the involvement of external male genitalia in Henoch-Schönlein vasculitis. Scrotal involvement can result from skin inflammation, epididymitis, orchitis, or testicular ischemia.
Item Description:10.3390/children9081154
2227-9067