Non-venereal genital disorders comprise a heterogeneous group of inflammatory, infectious (non-sexually transmitted), autoimmune, congenital and neoplastic conditions that affect the external genitalia in both sexes. Although genital symptoms commonly raise concern for sexually transmitted infections (STIs), a substantial proportion of genital complaints are due to conditions that are not sexually transmitted — examples include lichen simplex chronicus, psoriasis, vitiligo, fixed drug eruption, pearly penile papules, vestibular papillomatosis, and certain fungal or parasitic infections such as scabies localized to the genital area. Recognising these entities correctly is essential because misclassification as venereal disease produces unnecessary psychological distress (including venereophobia), leads to inappropriate treatment, and can delay the correct management pathway¹.

Epidemiological studies from tertiary care centres worldwide and from India indicate that non-venereal genital dermatoses are common among patients presenting with genital complaints, often outnumbering venereal causes in dermatology and vulvar clinics. Several hospital-based cross-sectional studies report that non-venereal conditions account for the majority of genital dermatoses seen in routine practice, with prevalence estimates in clinic populations varying by setting, study design and inclusion criteria. Spectrum and relative frequencies vary: some series identify scabies, pigmentary disorders (e.g., vitiligo), and lichen simplex chronicus as frequent diagnoses, while others report a high relative frequency of inflammatory dermatoses, fungal infections or drug eruptions depending on the population studied. These variations underline the importance of local, context-specific data from tertiary centres, which serve as referral hubs and thus reflect both common presentations and more complex or atypical disease².

Multiple factors contribute to under-reporting and delayed presentation of non-venereal genital conditions. Cultural stigma, embarrassment, limited awareness among patients that genital symptoms may be non-sexual in origin, and variable health-seeking behaviour all suppress early clinic attendance. In women, vulvar complaints are often under-recognised both by patients and by primary care providers, resulting in lower recorded prevalence despite potentially high community burden. In men, conversely, some clinic series show a male preponderance for non-venereal genital dermatoses, which may reflect differences in disease biology, presentation, or health-seeking patterns. These sociocultural and sex-specific dynamics complicate epidemiological interpretation and necessitate careful sociodemographic data collection in hospital studies³.

Diagnostic challenges are common in genital dermatology. Lesions that are benign and non-infectious may mimic sexually-transmitted infections clinically (for example, vestibular papillomatosis vs condyloma acuminata; pearly penile papules vs genital warts), and conversely, atypical presentations of STIs can be mistaken for non-venereal dermatoses. Diagnostic tools such as dermoscopy, careful history (including medication and allergy history), targeted laboratory tests, and, where indicated, biopsy, improve diagnostic accuracy. Recent studies emphasise the utility of dermoscopy in differentiating benign genital papules and inflammatory dermatoses, reducing unnecessary anxiety and treatment. Tertiary centres, with access to diagnostic aids and multidisciplinary input, are well placed to characterise the local pattern of disease and recommend practical diagnostic algorithms⁴.

Beyond diagnostic and therapeutic implications, non-venereal genital disorders carry significant psychosocial and quality-of-life impacts. Cross-sectional evidence shows measurable reductions in quality-of-life metrics among affected patients; complaints such as pruritus, pain, dyspareunia, and visible lesions often lead to sexual dysfunction, relationship stress, and mental health sequelae. These downstream effects provide a public-health rationale for systematic study: understanding clinical patterns, age and sex distribution, seasonal or occupational associations, comorbidities, and common misdiagnoses in a tertiary hospital setting will inform targeted education for clinicians and the public, reduce stigma, and guide allocation of diagnostic and therapeutic resources⁵.

Rationale and objectives. Despite several hospital-based series, gaps remain: many studies are single-centre, vary in inclusion criteria (male vs female, paediatric inclusion, infectious vs non-infectious), and differ in diagnostic rigor. Few recent studies comprehensively correlate clinical patterns with epidemiological variables such as age, occupation, comorbidities, prior treatments, and impact on quality of life in the same cohort⁶. A well-designed tertiary-centre study thus has value in (1) documenting the contemporary pattern of non-venereal genital disorders in the local population, (2) identifying common diagnostic pitfalls and referral pathways, (3) quantifying quality-of-life impact, and (4) suggesting context-appropriate clinical algorithms to reduce misdiagnosis and unnecessary STI workups. The present study aims to fill these gaps by providing a systematic clinical and epidemiological description of non-venereal genital disorders presenting to a tertiary care hospital, and by highlighting actionable recommendations for clinical practice.

 OBJECTIVES:  

To determine clinical and epidemiological pattern of non-venereal genital conditions that present as

1. a) genital lesions alone,
2. b) genital and skin lesions,
3. c) oro-genital lesions and
4. d) oro-genital and skin lesions in both males and females