Scrotal and penile edema in a patient with incomplete kawasaki disease: a case report and brief literature review.

BACKGROUND: Kawasaki disease (KD) is a medium artery vasculitis that predominantly affects children under age 5. Prompt diagnosis and treatment with IVIG and moderate dose aspirin is required to prevent the formation of coronary artery aneurysms. While scrotal edema and erythema have been seen in KD, here we present a distinctive case of incomplete Kawasaki with these features as well as penile edema. CASE PRESENTATION: A 2-year-old, unvaccinated, African American male presented with 4 days of fever, bilateral limbic sparing conjunctivitis, a papular rash, unilateral shotty cervical lymphadenopathy, mild right-hand edema, and scrotal and penile edema and erythema. His labs were significant for sterile pyuria, elevated ALT, anemia for age, and hypoalbuminemia. He was diagnosed with incomplete Kawasaki disease and was treated with IVIG and moderate dose aspirin. Echocardiogram was negative for coronary aneurysms. His symptoms resolved and he was discharged home with low dose aspirin. At his 2-week follow up, he remained well-appearing with no refractory Kawasaki symptoms. CONCLUSION: This is a unique case of penile edema in KD which to our knowledge has not been previously reported in literature. An understanding of genitourinary symptoms in Kawasaki disease can help timely diagnosis and treatment of the disease.

Human mpox presenting with penile edema and ulcer: A case report.

Human mpox, which has spread worldwide since May 2022, is characterized by symptoms involving the genital area; however, its treatment methods and clinical course are not completely understood. Furthermore, penile swelling in human mpox can be difficult to differentiate from cellulitis and antibiotic use has been reported in such cases. Herein, we report a case of human mpox in Japan with prominent penile swelling and persistent penile ulcers that improved without specific treatment. The patient was a Japanese man in his 20s with a history of having sexual intercourse with men frequently. He visited Tokyo Metropolitan Toshima Hospital because of a fever and rash in the genital area. Physical examination revealed vesicles on the limbs, penile pigmentation, and significant penile swelling and redness. There were no signs of cellulitis and symptomatic treatment was initiated with outpatient follow-up. After 7 days, an improving trend in penile swelling, redness, and pain was observed. However, a partially black skin ulcer with exudate was observed at the left coronal sulcus of the penis. Therefore, the symptomatic treatment was continued. On illness day 28, the penile swelling completely improved; however, the penile ulcer and pain persisted, and the exudate was observed again. By illness day 63, the pain in his anogenital area had disappeared, and the penile skin ulcer had healed. The following observations were noted in this case: (i) human mpox can improve without specific treatment such as tecovirimat administration and (ii) skin lesions in the genital area may change over time.

Foscarnet-Induced Penile Ulceration.

This case report describes an uncircumcised male individual with tender perimeatal erythema and ulceration extending to the right glans.

[Idiopathic partial thrombosis of the corpus cavernosum (IPTCC) : A rare urological emergency]. / Die idiopathische partielle Thrombose des Corpus cavernosum (IPTCC) : Ein Kolibri der urologischen Notfallversorgung.

BACKGROUND: Idiopathic partial thrombosis of the corpus cavernosum (IPTCC) is a rare, semi-acute disease in young, healthy men. In addition to an anatomical predisposition, perineal microtrauma is stated as the main risk factor. MATERIALS AND METHODS: A case report and the results of a literature search with descriptive-statistical processing of 57 peer-reviewed publications are presented. A therapy concept was drawn up for clinical practice. RESULTS: Our patient was treated conservatively and was consistent with the 87 cases which have been published since 1976. IPTCC is a disease of young men (33.2 years, range 18-70), which is associated with pain and perineal swelling in 88%. Sonography and contrast-enhanced magnetic resonance imaging (MRI) proved to be the diagnostic modality of choice, demonstrating the thrombus and in 89% a connective tissue membrane inside the corpus cavernosum. Treatment included antithrombotic and analgesic (n = 54, 62.1%), surgical (n = 20, 23%), analgesic (n = 8, 9.2%), via injection (n = 2, 2.3%), as well as radiological interventional (n = 1, 1.1%) options. In 12 cases, erectile dysfunction, mostly temporary, which required phosphodiesterase (PDE)-5 therapy developed. Recurrence and prolonged courses were rare. CONCLUSION: IPTCC is a rare disease in young men. Conservative therapy with antithrombotic and analgesic treatment has shown good chances of full recovery. If relapse occurs or the patient refuses antithrombotic treatment, operative/alternative therapy management should be considered.

2022 European guideline for the management of balanoposthitis.

BACKGROUND: This guideline is an update to the 2014 edition of the European guideline for the management of balanoposthitis. Balanoposthitis describes inflammation of the glans penis and prepuce and is caused by a range of disparate conditions including infection, dermatoses and premalignancy. OBJECTIVE: The main objectives of this guideline are to aid recognition of the symptoms and signs and complications of penile skin conditions and to offer recommendations on the diagnostic tests and treatment for a selected group of these conditions. METHODS: The previous guideline was updated following a literature review and priority was given to randomized controlled trial and systematic review evidence. RESULTS: The updated guideline includes amended management for infective balanitis to provide clear guidance for Group A streptococcal infections, management of on going Lichen sclerosus (to include circumcision and supportive management to reduce the recurrence of genital herpes and warts), additional regimens for Zoonoid change, use of calcineurin inhibitors in management and risk of premalignancy and change of nomenclaturefrom Premalignant conditions to Penile Intraepithelial neoplasia (PeIN). CONCLUSION: Balanoposthitis has a widerange of causes high quality evidence specific to the management of penile disease is not available for all the conditions described.

[Solitary ulcer of unknown etiology on the glans penis]. / Solitäres Ulkus unklarer Ätiologie an der Glans penis.

Ulcerations of the prepuce or foreskin of the penis are rare in the day-to-day life of a urologist. The most common differential diagnosis is invasive penile cancer, which is why other diagnoses are often overshadowed. We report a case of a syphilitic lesion which was initially misdiagnosed as penile cancer. Considering the rising incidence of syphilis worldwide, syphilis should be considered as a possible cause of any solitary penile ulcer.

An unusual presentation of penile Mondor's disease in an HIV-positive patient.

Penile Mondor's disease (PMD), or thrombosis of the dorsal vein, is an under-reported benign condition. Its aetiology is poorly understood. Clinically, it presents as a palpable cord in the dorsal vein of the penis, with pain or local discomfort, especially during erection. PMD may be diagnosed based on the medical history and physical examination. Management of the condition is conservative, with practitioners opting for various strategies including sexual/masturbatory abstinence, localised anticoagulant topical therapy and oral nonsteroidal anti-inflammatory drugs. In many cases, PMD will resolve within 4-8 weeks of presentation. Thrombectomy and resection of the superficial penile vein are applied surgically in patients refractory to the medical treatment. We describe the case of a 33-year-old patient known to have HIV who presented for severe painful dorsal induration and swelling of the proximal third of the penis. The patient had no recent history of sexual intercourse, penile trauma or other well-known risk factors for PMD. The physical examination was unequivocal, so a Doppler ultrasound was performed. A diagnosis of PMD was made and conservative treatment was prescribed. During a follow-up visit after 6 weeks, the patient had no symptoms and physical examination did not reveal anything pathological.