EADV Symposium 2026 sessions spotlight
Session type: What's new
- Saturday, 9 May
- 12:30 - 14:00 EEST
- Skalkotas Hall
Presentation details:
Is it syphilis?
Electra Nicolaidou, Greece
With the incidence of syphilis rising sharply across Europe in recent years—particularly since 2020—prompt diagnosis and appropriate treatment are of paramount importance. Often referred to as the “great imitator” due to its wide spectrum of clinical presentations, especially during the secondary stage, syphilis can challenge even highly experienced clinicians.
Thus, the focus of this presentation will be the differential diagnosis of clinical signs and symptoms, that may or may not be caused by syphilis. Apart from anogenital and generalized skin rashes, special attention will also be given to the less common ocular and auditory manifestations, that may be present during secondary and tertiary disease. Recent advances in laboratory diagnostics for confirming syphilis infection will also be discussed.
The presentation will further review the clinical features of common anogenital dermatoses (such as lichen sclerosus and lichen planus), penile and vulvar intraepithelial neoplasia and cancer. In addition, other sexually transmitted infections such as genital herpes and anogenital warts will be addressed in the context of differential diagnosis.
Key learning objectives
At the end of the presentation, participants will be able to:
- Distinguish syphilitic chancre from other causes of anogenital ulcers
- Differentiate condylomata lata from anogenital warts
- Identify three auditory symptoms that may be caused by otosyphilis
- Select the appropriate laboratory test for diagnosing each stage of the disease
- Recognize the main clinical manifestations of at least three anogenital dermatoses
Presentation details:
The "neglected" balanitis
Carmen Lisboa Silva, Portugal
Balanitis encompasses a wide range of disorders, including infective, inflammatory and premalignant conditions. A comprehensive assessment combining clinical history, morphological features, and often, basic laboratorial tests become crucial to accurately managing balanitis
Despite being a common clinical condition, balanitis has received relatively little attention in the medical literature. By definition, balanitis refers to inflammation of the glans penis, whereas posthitis denotes inflammation of the foreskin; the coexistence of both conditions, termed balanoposthitis, is common. However, for simplicity, the term balanitis will be used to refer to both conditions. Balanitis encompasses a wide range of disorders with similar clinical presentations. Differentiating the underlying aetiologies can be challenging, but it is essential for guiding appropriate management.
Balanitis can occur at any age and it is more common in uncircumcised men. Prepuce dysfunction is a recognized contributing factor. The disease usually presents as an acute episode, although chronic or recurrent forms may also occur.
Balanitis may be caused by a wide range of conditions, including infections, inflammatory dermatoses, and premalignant disorders. Poor or inadequate hygiene in uncircumcised males, as well as local trauma, are important predisposing factors for balanitis.
A range of infective agents have been isolated more frequently in patients presenting with balanoposthitis and may not be easily differentiated by clinical findings. These include fungal infections such as Candida spp., bacterial infections including Streptococcus spp. and anaerobes. Candida balanitis is the most common infectious balanitis and it accounts for 30% to 35% of all patients with balanitis.
There are several host factors that predispose to candida balanitis, such as poorly-controlled diabetes mellitus, the use of antidiabetic drugs sodium–glucose cotransporter 2 inhibitors (increases the risk 2-3 times), recent antibiotic use, immunosuppression (HIV, immunosuppressive therapy as corticosteroids and IL-17A inhibitors).
Several STIs have been reported as causing balanitis, particularly syphilis and Chlamydia trachomatis infection. Lichen planus, lichen sclerosus, Zoon’s balanitis, contact dermatitis, psoriasis, seborrhoeic dermatitis, and fixed drug eruption are among the inflammatory conditions that may cause balanitis. Persistent balanitis may be due to a premalignant condition. Lichen sclerosus and chronic HPV infection may induce penile intraepithelial neoplasia.
A comprehensive assessment combining clinical history (including a comprehensive STI / HIV risk assessment), morphological features, and often, basic laboratorial tests become crucial to accurately identifying and managing balanitis. Dermoscopy can help differentiate between inflammatory and infectious balanitis. Biopsy is recommended if the condition persists or/and malignant lesions are concerned. The general management of patients with balanitis aims to minimize urinary and sexual dysfunction, exclude genital malignancy, treat premalignant disease, and diagnose and manage sexually transmitted infections.