Pyoderma gangranosum of the penis

Abstract

We report a patient who developed pyoderma gangrenosum in the penis with invasion of the distal urethra. The patient was treated with prednisolone and thalidomide, followed by a reconstructive surgical repair using a scrotal island flap. We report this case with a brief review of the literature.

Keywords: Penis; Pyoderma Gangrenosum.

Fig. 1

There are painful purulent ulcerations on the distal dorsal penile shaft and glans of the penis with meatal stenosis and multiple urethrocutaneous fistula.

Fig. 2

Histologic findings of the skin lesion. Inflammatory cells infiltrate to the ulcerated dermis (H&E stain, original magnification ×100).

Fig. 3

After medical treatment, the skin ulceration improved with re-epithelialization. However, the penile deformity (dorsal curvature) aggravated, which was indicative for an early reconstructive operation.

Fig. 4

Intraoperative findings. (A, B) The necrotic tissue was excised and the skin defects of the glans and distal shaft were repaired with a scrotal island flap. Urethral and suprapubic catheterization were performed. (C) There were no urethrocutaneous fistulas without recurrence of pyoderma gangrenosum throughout the postoperative 90 days.