Thickening of the prepuce may result in narrowing of the foreskin. The diagnosis is generally made by clinical features. Imaging studies including CT scan, gallium scan, ultrasound and magnetic resonance imaging may serve as valuable adjuncts. X-ray of urethra after filling it with a dye is diagnostic for urethral fistula. Differential diagnosis of the genitourinary lesions includes syphilis, herpes simplex, hidradenitis suppurativa, tuberculosis, actinomycosis, lymphogranuloma venereum, leishmaniasis, chancroid, Bechet's syndrome and filariasis.
Treatment is controversial.
Metronidazole and prednisone have been inconsistently shown to be of benefit. Azathioprine and 6-mercaptopurine are frequently used. Other treatments including diuretics, ascorbic acid or zinc supplements have been tried. Scrotal support may alleviate scrotal edema. Relapse may occur when medical treatment is withdrawn.