Update Notification

Discuss this Case with Other Dermatologists *new*

Main Index

Previous Grand Rounds

Submission Guidelines

AOCD Home Page

Contact Editor

Rash on the Penis

Sun Coast Hospital, NOVA Southeastern University Dermatology Program
Largo, Florida

November, 2002

Presenters: Matthew Muellenhoff , DO (2nd year resident)
Thi Tran, DO (2nd year resident)
Frank Armstrong , DO (3rd year resident)
Kathleen Soe, DO (3rd year resident)
Greg Houck, DO (1st year resident)
Marya Cassandra, DO (1st year resident)

Program Director: Richard Miller, D.O.

Clinical Presentation

58 year-old uncircumcised white male

History

A 58 year-old uncircumcised white male presented to our dermatology clinic for evaluation of a “rash” on his penis for >5 years. Past medical history was significant for hypertension, hyperlipidemia and coronary artery disease. He had used over the counter products such as Gold-Bond ointment, Vaseline and cortisone without benefit. Localized irritation with coitus, duration of the “rash” and concern of “what it is” brought him to our clinic.

Physical Examination

Physical examination revealed a well-nourished, middle-aged uncircumcised white male in no acute distress. The glans penis revealed a discrete, glistening erythematous plaque. Penile discharge, ulcerations and adenopathy were absent. The ocular and oral mucosa failed to reveal any lesions. The patient denied any significant review of systems, specifically, the musculoskeletal and ophthalmological. The patient also claimed to be monogamous for the previous 10 years and denied any risk factors for sexually transmitted diseases.

A 2 week trial of ciclopirox cream and triamcinolone acetonide 0.01% cream failed to provide any benefit. A punch biopsy was performed at the follow-up visit. Serologies for HIV and syphilis were negative. Culture of the plaque revealed normal commensal flora. Histopathologic findings included, a thin epidermis, uniform intercellular edema, and pancake like keratinocytes. The upper dermis demonstrated a lichenoid infiltrate with copious plasma cells. Capillary dilatation was also noted.

Differential Diagnosis