- Scrotal and Penile Ulcer in Juvenile Dermatomyositis: An Unusual Occurrence. [Journal Article]
- JCJ Clin Rheumatol 2018 Mar 21
- An Emergency Department Presentation of Secondary Syphilis. [Journal Article]
- MMMil Med 2018 Mar 14
- In the United States, the rate of primary and secondary syphilis has increased by 18% in 2016, the highest rate since 1993. These patients can often present to the emergency department (ED) in variou...
In the United States, the rate of primary and secondary syphilis has increased by 18% in 2016, the highest rate since 1993. These patients can often present to the emergency department (ED) in various stages. Although syphilis is well described in the literature, there is a paucity of ED reports of atypical cases. A 22-yr-old male presented to the ED complaining of neck pain. The patient was found to have right-sided tender cervical lymphadenopathy causing neck pain. A thorough physical exam revealed diffuse lymphadenopathy. Without an obvious infectious etiology, the patient underwent a broad workup, which revealed a reactive rapid plasma reagin (RPR) assay with a titer of 1:64. The patient had no history of the classic painless penile ulcer. The ED presentation of secondary syphilis can be very insidious, and physicians should be aware of its various presentations.
- Disseminated fusariosis emerged from prolonged local genital infection after cord blood transplantation. [Journal Article]
- JIJ Infect Chemother 2018 Jan 16
- Disseminated fusariosis (DF) is a rare life threatening fungal infection in immunocompromised hosts. We herein report a case of a fatal DF mimicking varicella zoster virus (VZV) infection that was em...
Disseminated fusariosis (DF) is a rare life threatening fungal infection in immunocompromised hosts. We herein report a case of a fatal DF mimicking varicella zoster virus (VZV) infection that was emerged from a localized genital infection during cord blood transplantation (CBT) in a patient with severe aplastic anemia (SAA). The patient developed an ulcer following small painful vesicles mimics herpes simplex virus infection (HSV) on the glans penis before CBT, but a Fusarium species was identified. Despite administration of voriconazole, liposomal amphotericin B and granulocyte transfusion, the lesion was extended to extensive skin looked like VZV infection and the patients died after CBT. Massive fusarium infiltration was detected in multiple organs at autopsy. A genetic analysis of the mold identified Fusarium solani after his death. It should be noted that in patients with fusarium infection, localized and disseminated lesions of fusarium infection sometimes mimic HSV and VZV infections, which hampers an early diagnosis.
- Noninfectious Penile Lesions. [Journal Article]
- AFAm Fam Physician 2018 Jan 15; 97(2):102-110
- Noninfectious penile lesions are classified by clinical presentation as papulosquamous (e.g., psoriasis), inflammatory (e.g., lichen sclerosus, lichen nitidus, lichen planus), vascular (e.g., angioke...
Noninfectious penile lesions are classified by clinical presentation as papulosquamous (e.g., psoriasis), inflammatory (e.g., lichen sclerosus, lichen nitidus, lichen planus), vascular (e.g., angiokeratomas), or neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). Psoriasis presents as red or salmon-colored plaques with overlying silvery scales, often with extragenital cutaneous lesions. Lichen sclerosus presents as a phimotic, hypopigmented prepuce or glans penis with a cellophane-like texture. Lichen nitidus usually produces asymptomatic pinhead-sized, hypopigmented papules. The lesions of lichen planus are pruritic, violaceous, polygonal papules that are typically systemic. Angiokeratomas are typically asymptomatic, well-circumscribed, red or blue papules, often with annular or figurate configurations. Carcinoma in situ should be suspected if there are velvety red or keratotic plaques on the glans penis or prepuce, whereas invasive squamous cell carcinoma presents as a painless lump, ulcer, or fungating mass. Some benign lesions, such as psoriasis and lichen planus, may mimic carcinoma in situ or invasive squamous cell carcinoma. Biopsy is indicated if the diagnosis is in doubt or neoplasm cannot be excluded. The management of benign noninfectious penile lesions usually involves observation, topical corticosteroids, or topical calcineurin inhibitors. Neoplastic lesions generally warrant organ-sparing surgery.
- Blueprint unknown: a case for multidisciplinary management of advanced penile mycosis fungoides. [Journal Article]
- CJCan J Urol 2017; 24(6):9139-9144
- A 64-year-old man presented with a 2 week history of progressive phimosis and painful ulcer on his penile meatus. He underwent penile preserving excision, and subsequent pathological examination conf...
A 64-year-old man presented with a 2 week history of progressive phimosis and painful ulcer on his penile meatus. He underwent penile preserving excision, and subsequent pathological examination confirmed T-cell non-Hodgkin lymphoma with immunohistochemical features of large cell transformation of mycosis fungoides. The penis was further treated with local external beam radiotherapy consisting of 27 Gy in 15 fractions and systemic mini-CHOP chemotherapy. An organ-preserving tissue response has since been achieved. This case is the first of its kind in the literature and firmly highlights the role of multidisciplinary management for this rare malignancy.
- Compression Stockings and Pressure Ulcers: Case Series of a Neglected Issue. [Journal Article]
- CCureus 2017 Oct 10; 9(10):e1763
- Pressure ulcers develop in patients who endure long periods of immobilization, often caused by conditions such as musculoskeletal and neurological diseases. Pressure ulcers adversely affect the patie...
Pressure ulcers develop in patients who endure long periods of immobilization, often caused by conditions such as musculoskeletal and neurological diseases. Pressure ulcers adversely affect the patient and increase caregiver burden and healthcare costs. Typical sites for these ulcers include the sacrum, trochanters, and heels; they also occur on the nape of the neck, penis, nostrils, helix of the ear, and upper back. Compression stockings are commonly used to prevent and stop the progression of venous disorders, including deep vein thrombosis, but their role in the development of pressure ulcers is not well known. We describe three case reports of pressure ulcer development due to prolonged application of compression stockings. In each case, the nursing staff who were primarily responsible for the prevention of pressure ulcers applied the stockings continuously without any intermittent relief. Moreover, the stockings did not include manufacturer instructions, such as recommended exposure times and applications. We recommend that nursing staff be trained in pressure relief and prevention of pressure ulcers, including rare occurrences, and that manufacturers give detailed guidance regarding the safe use of compression stockings.
- Surgical Management of Penile Lesions Secondary to Foreign Body Reaction: A Case Report and Systematic Review. [Journal Article]
- ASAesthet Surg J 2017 Nov 06
- CONCLUSIONS: Restoration of the penile shape preserving the functionality and maintaining a good physician-patient relationship may be a challenge. The scrotal pouch may be advantageous for patch grafting of penile soft-tissue lesions, owing to its skin laxity and good blood supply. A less aggressive surgical approach has the benefits of shorter healing time and fewer early complications. Penile injuries are best treated by experienced surgeons on a case-by-case basis with care given to identify the most appropriate treatment.
- Penile ulcer in a 58-year-old HIV-positive patient after local injection of methamphetamine (crystal meth). [Letter]
- JDJ Dtsch Dermatol Ges 2017; 15(11):1149-1151
- Chronic penile ulcer as the first manifestation of HIV infection. [Journal Article]
- BCBMJ Case Rep 2017 Aug 07; 2017
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- Herpes neolabialis: herpes simplex virus type 1 infection of the neolabia in a transgender woman. [Case Reports]
- IJInt J STD AIDS 2017; 28(8):841-843
- A 24-year-old transgender woman consulted our outpatient clinic with a painful, itchy and red left labia. She underwent a penile inversion vaginoplasty 18 months before presentation. At physical exam...
A 24-year-old transgender woman consulted our outpatient clinic with a painful, itchy and red left labia. She underwent a penile inversion vaginoplasty 18 months before presentation. At physical examination of the left labia, erythema, edema and herpetic vesicles with ulceration were observed. A vesicle fluid swab was obtained and the presence of herpes simplex virus type 1 (HSV-1) was detected by PCR assay. Treatment consisted of oral valaciclovir (500 mg twice daily) for a total of five days.Topically-applied lidocaine cream (3%) was used for pain management. Treatment gave symptom relief in five days. At physical examination 14 days after symptom onset, there were no signs of active infection. To our knowledge, this is the first case report of HSV-1 infection of the neolabia in a transgender woman.