Causes of Granuloma inguinale
Granuloma inguinale Causes: Book Excerpts
Related information on causes of Granuloma inguinale:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Granuloma inguinale may be found in:
Causes of Granuloma inguinale: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the causes of Granuloma inguinale.
Genital Skin Lesions:
Differential Diagnosis
(In a Page: Signs and Symptoms)
-
Herpes simplex virus (HSV-1 and HSV-2) is the most common cause of genital lesions in the U.S.
–Presents with prodromal tingling and genital discomfort before lesions
–Lesions are always painful and appear as grouped vesicles on an erythematous base -
Condyloma acuminatum (“warts,” HPV)
–Etiologic agent is human papilloma virus
–Lesions usually painless and pearly with a smooth surface but may be filiform, fungating, and lobulated
Tinea cruris
–Inguinal erythema with itch or tenderness
–Always spares the scrotum
Candida intertrigo
–Inguinal erythema with itch or tenderness
–Often very red with satellite lesions
–Frequently involves the labia or scrotum Syphilis
–Primary stage: Painless solitary ulcer (chancre) on labia, penis, or oral mucosa that heals in 2–3 weeks
–Secondary stage: Condyloma lata (moist hypertrophic papules on genital and oral regions)
–Tertiary stage: Cardiac, neurologic, and other systemic effects
-
Molluscum contagiosum
–Multiple, very small, painless, flesh-colored nodules with umbilicated centers
-
Chancroid
–Etiologic agent is Haemophilus ducreyi
–Painful, solitary, and erythematous lesions
–May present with dyspareunia and/or dysuria
Erythrasma
Lymphogranuloma venereum
Granuloma inguinale
Behçet syndrome
–Oral and genital ulcers, retinitis, uveitis
Lichen planus
Scabies
Zoon's plasma cell balanitis
Less common etiologies (“zebras”) include inverse psoriasis, seborrheic dermatitis, genital squamous cell carcinoma, extramammary Paget's disease, plaque psoriasis, and fixed drug eruptions
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Genital lesions in the male:
Medical causes
(Handbook of Signs & Symptoms (Third Edition))
Balanitis and balanoposthitis
Typically, balanitis (glans infection) and posthitis (prepuce infection) occur together (balanoposthitis), causing painful ulceration on the glans, foreskin, or penile shaft. Ulceration is usually preceded by 2 to 3 days of prepuce irritation and soreness, followed by a foul discharge and edema. The patient may then develop features of acute infection, such as a fever with chills, malaise, and dysuria. Without treatment, the ulcers may deepen and multiply. Eventually, the entire penis and scrotum may become gangrenous, resulting in life-threatening sepsis.
Bowen’s disease
Bowen’s disease is a painless, premalignant lesion that commonly occurs on the penis or scrotum, but may also appear elsewhere. It appears as a brownish red, raised, scaly, indurated plaque with well-defined borders, which may ulcerate at its center.
Chancroid
Chancroid is an STD that’s characterized by the eruption of one or more lesions, usually on the groin, inner thigh, or penis. Within 24 hours, the lesion changes from a reddened area to a small papule. (A similar papule may erupt on the tongue, lip, breast, or umbilicus.) It then becomes an inflamed pustule that rapidly ulcerates. This painful — and usually deep — ulcer bleeds easily and commonly has a purulent gray or yellow exudate covering its base. Rarely more than 2 cm in diameter, it’s typically irregular in shape. The inguinal lymph nodes also enlarge, become very tender, and may drain pus.
Folliculitis and furunculosis
Hair follicle infection may cause red, sharply pointed lesions that are tender and swollen with central pustules. If folliculitis progresses to furunculosis, these lesions become hard, painful nodules that may gradually enlarge and rupture, discharging pus and necrotic material. Rupture relieves the pain, but erythema and edema may persist for days or weeks.
Genital herpes
Caused by herpesvirus type 1 or 2, genital herpes is an STD that produces fluid-filled vesicles on the glans penis, foreskin, or penile shaft and, occasionally, on the mouth or anus. Usually painless at first, these vesicles may rupture and become extensive, shallow, painful ulcers accompanied by redness, marked edema, and tender, inguinal lymph nodes. Other findings may include a fever, malaise, and dysuria. If the vesicles recur in the same area, the patient usually feels localized numbness and tingling before they erupt. Associated inflammation is typically less marked.
Genital warts
Most common in sexually active males, genital warts initially develop on the subpreputial sac or urethral meatus, and less commonly on the penile shaft; they then spread to the perineum and perianal area. These painless warts start as tiny red or pink swellings that may grow to 4" (10 cm) and become pedunculated. Multiple swellings are common, giving the warts a cauliflower appearance. Infected warts are also malodorous.
Leukoplakia
Leukoplakia is a precancerous disorder that’s characterized by white, scaly patches on the glans and prepuce accompanied by skin thickening and occasionally fissures.
Pediculosis pubis
Pediculosis pubis is a parasitic infestation that’s characterized by erythematous, itching papules in the pubic area and around the anus, abdomen, and thigh. Inspection may detect grayish white specks (lice eggs) attached to hair shafts. Skin irritation from scratching in these areas is common.
Penile cancer
Penile cancer usually produces a painless, enlarging wartlike lesion on the glans or foreskin. However, if the foreskin becomes unretractable, the patient may experience localized pain. Examination may reveal a foul-smelling discharge from the prepuce, a firm lump in the glans, and enlarged lymph nodes. Late signs and symptoms may include dysuria, pain, bleeding from the lesion, and urine retention and bladder distention associated with urinary tract obstruction.
Scabies
Mites that burrow under the skin in scabies may cause crusted lesions or large papules on the glans and shaft of the penis and on the scrotum. Lesions may also occur on the wrists, elbows, axillae, and waist. They’re usually raised, threadlike, and 1 to 10 cm long and have a swollen nodule or red papule that contains the mite. Nocturnal itching is typical and commonly causes excoriation.
Syphilis
Two to four weeks after exposure to the spirochete Treponema pallidum, one or more primary lesions, or chancres, may erupt on the genitalia; occasionally, they also erupt elsewhere on the body, typically on the mouth or perianal area. The chancre usually starts as a small, red, fluid-filled papule and then erodes to form a painless, firm, indurated, shallow ulcer with a clear base and a scant, yellow serous discharge or, less commonly, a hard papule. This lesion gradually involutes and disappears. Painless, unilateral regional lymphadenopathy is also typical.
Tinea cruris
Also called jock itch, tinea cruris is a superficial fungal infection that usually causes sharply defined, slightly raised, scaling patches on the inner thigh or groin (typically bilaterally) and, less commonly, on the scrotum and penis. Pruritus may be severe.
Urticaria
Urticaria is a common allergic reaction that’s characterized by intensely pruritic hives, which may appear on the genitalia, especially on the foreskin or shaft of the penis. These distinct, raised, evanescent wheals are surrounded by an erythematous flare.
Other causes
Drugs
Phenolphthalein, barbiturates, and certain broad-spectrum antibiotics, such as tetracycline and sulfonamides, may cause a fixed drug eruption and a genital lesion.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Genital warts:
Causes
(Professional Guide to Diseases (Eighth Edition))
Infection with one of the more than 70 known strains of HPV causes genital warts, which are transmitted through sexual contact. The warts grow rapidly in the presence of heavy perspiration, poor hygiene, or pregnancy and commonly accompany other genital infections.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Genital lesions in the male:
Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))
Balanitis and balanoposthitis
Typically, balanitis (glans infection) and posthitis (prepuce infection) occur together (balanoposthitis), causing painful ulceration on the glans, foreskin, or penile shaft. Ulceration is usually preceded by 2 to 3 days of prepuce irritation and soreness, followed by a foul discharge and edema. The patient may then develop features of acute infection, such as fever with chills, malaise, and dysuria. Without treatment, the ulcers may deepen and multiply. Eventually, the entire penis and scrotum may become gangrenous, resulting in life-threatening sepsis.
Bowen’s disease
This painless, premalignant lesion usually occurs on the penis or scrotum but may appear elsewhere. It appears as a brownish red, raised, scaly, indurated, well-defined plaque, which may have an ulcerated center.
Candidiasis
When this infection involves the anogenital area, it produces erythematous, weepy, circumscribed lesions, usually under the prepuce. Vesicles and pustules may also develop.
Chancroid
This STD is characterized by the eruption of one or more lesions, usually on the groin, inner thigh, or penis. Within 24 hours, the lesion changes from a reddened area to a small papule. (A similar papule may erupt on the tongue, lip, breast, or umbilicus.) It then becomes an inflamed pustule that rapidly ulcerates. This painful—and usually deep—ulcer bleeds easily and commonly has a purulent gray or yellow exudate covering its base. Rarely more than 2 cm in diameter, it’s typically irregular in shape. The inguinal lymph nodes also enlarge, become very tender, and may drain pus.
Erythroplasia of Queyrat
This premalignant lesion is a form of Bowen’s disease that appears exclusively under the foreskin of an uncircumcised penis. It typically appears as a red, raised, well-defined, velvety, indurated plaque, which may have an ulcerated center.
Folliculitis and furunculosis
Hair follicle infection may cause red, sharply pointed, tender and swollen lesions with central pustules. If folliculitis progresses to furunculosis, these lesions become hard, painful nodules that may gradually enlarge and rupture, discharging pus and necrotic material. Rupture relieves the pain, but erythema and edema may persist for days or weeks.
Fournier’s gangrene
In this life-threatening form of cellulitis, the scrotum suddenly becomes tense, swollen, painful, red, warm, and glossy. As gangrene develops, the scrotum also becomes moist. Fever and malaise may accompany these scrotal changes.
Genital herpes
Caused by herpesvirus type I or II, this STD produces fluid-filled vesicles on the glans penis, foreskin, or penile shaft and, occasionally, on the mouth or anus. Usually painless at first, these vesicles may rupture and become extensive, shallow, painful ulcers accompanied by redness, marked edema, and tender, inguinal lymph nodes. Other findings may include fever, malaise, and dysuria. If the vesicles recur in the same area, the patient usually feels localized numbness and tingling before they erupt. Associated inflammation is typically less marked.
Genital warts
Most common in sexually active males, genital warts initially develop on the subpreputial sac, urethral meatus or, less commonly, the penile shaft and then spread to the perineum and the perianal area. These painless warts start as tiny red or pink swellings that may grow to 10 cm and become pedunculated. Multiple swellings are common, giving the warts a cauliflower-like appearance. Infected warts are also malodorous.
Granuloma inguinale
Initially, this rare, chronic STD causes a single painless macule or papule on the external genitalia that ulcerates and becomes a raised, beefy red lesion with a granulated, friable border. Later, other painless lesions may erupt and blend together on the glans penis, foreskin, or penile shaft. Lesions may also develop on the nose, mouth, or pharynx. Eventually, these lesions become infected, malodorous, and painful and may be accompanied by fever, weight loss, malaise, and signs of anemia such as weakness. Later, they’re marked by fibrosis, keloidal scarring, and depigmentation.
Leukoplakia
This precancerous disorder is characterized by white, scaly patches on the glans and prepuce accompanied by skin thickening and occasionally fissures.
Lichen planus
Small, shiny, polygonal, violet papules develop on the glans penis in this disorder. These papules are less than 3 cm in diameter and have white, lacy, milky striations. They may be linear or coalesce into plaques. Occasionally, oral lesions precede genital lesions; lesions may also appear on the lower back, ankles, and lower legs. Accompanying findings may include pruritus, distorted nails, and alopecia.
Lymphogranuloma venereum
One to three weeks after sexual exposure, this STD may produce a penile erosion or papule that heals rapidly and spontaneously; in fact, it often goes unnoticed. A few days or weeks later, the inguinal and subinguinal nodes enlarge, becoming painful, fluctuant masses. If these nodes become infected, they rupture and form sinus tracts, discharging a thick, yellow, granular secretion. Eventually, a scar or chronic indurated mass forms in the inguinal area. Systemic signs and symptoms include a rash, fever with chills, headache, migratory joint and muscle pain, malaise, and weight loss.
Pediculosis pubis
This parasitic infestation is characterized by erythematous, pruritic papules in the pubic area and around the anus, abdomen, and thigh. Inspection may detect grayish white specks (lice eggs) attached to hair shafts. Skin irritation from scratching in these areas is common.
Penile cancer
This cancer usually produces a painless, enlarging wartlike lesion on the glans or foreskin. The patient may experience localized pain, however, if the foreskin becomes unretractable. Examination may reveal a foul-smelling discharge from the prepuce, a firm lump in the glans, and enlarged lymph nodes. Late signs and symptoms may include dysuria, pain, bleeding from the lesion, and urine retention and bladder distention associated with obstruction of the urinary tract.
Psoriasis
Red, raised, scaly plaques typically affect the scalp, chest, knees, elbows, and lower back. When they occur on the groin or on the shaft and glans of the penis, the plaques are usually redder; on an uncircumcised penis, the characteristic silver scales are absent. The patient commonly reports itching and, possibly, pain from dry, cracked, encrusted lesions. Nail pitting and joint stiffness may also occur.
Scabies
In this disorder, mites that burrow under the skin may cause crusted lesions or large papules on the glans and shaft of the penis and on the scrotum. Lesions may also occur on the wrists, elbows, axillae, and waist. They’re usually raised, threadlike, and 1 to 10 cm long and have a swollen nodule or red papule that contains the mite. Nocturnal pruritus is typical and commonly causes excoriation.
Seborrheic dermatitis
Initially, this disorder causes erythematous, dry or moist, greasy, scaling papules with yellow crusts that enlarge to form annular plaques. These pruritic plaques may affect the glans and shaft of the penis, scrotum, and groin as well as the scalp, chest, eyebrows, back, axillae, and umbilicus.
Syphilis
Two to four weeks after exposure to the spirochete Treponema pallidum, one or more primary lesions, or chancres, may erupt on the genitalia; occasionally, they also erupt elsewhere on the body, typically on the mouth or perianal area. The chancre usually starts as a small, red, fluid-filled papule and then erodes to form a painless, firm, indurated, shallow ulcer with a clear base and a scant yellow serous discharge or, less commonly, a hard papule. This lesion gradually involutes and disappears. Painless, unilateral regional lymphadenopathy is also typical.
Tinea cruris
Also called “jock itch,” this superficial fungal infection usually causes sharply defined, slightly raised, scaling patches on the inner thigh or groin (often bilaterally) and, less commonly, on the scrotum and penis. Pruritus may be severe.
Urticaria
This common allergic reaction is characterized by intensely pruritic hives, which may appear on the genitalia, especially on the foreskin or shaft of the penis. These distinct, raised, evanescent wheals are surrounded by an erythematous flare.
Other causes
Drugs
Barbiturates and certain broad-spectrum antibiotics, such as tetracycline and sulfonamides, may cause a fixed drug eruption and a genital lesion.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Genital Ulcer:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Herpes simplex
❑ Trauma
❑ Syphilis
❑ Fixed drug eruption
❑ Behçet syndrome
❑ Candida balanitis
❑ Granuloma inguinale
❑ Chancroid
❑ Lymphogranuloma venereum
❑ Bowen disease
❑ Carcinoma of the penis
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Genital lesions in the male:
Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Balanitis and balanoposthitis
Typically, balanitis (glans infection) and posthitis (prepuce infection) occur together (balanoposthitis), causing painful ulceration on the glans, foreskin, or penile shaft. Ulceration is usually preceded by 2 to 3 days of prepuce irritation and soreness, followed by a foul discharge and edema. The patient may then develop features of acute infection, such as fever with chills, malaise, and dysuria. Without treatment, the ulcers may deepen and multiply. Eventually, the entire penis and scrotum may become gangrenous, resulting in life-threatening sepsis.
Bowen’s disease
Bowen’s disease, a painless, premalignant lesion, commonly occurs on the penis or scrotum but may also appear elsewhere. It appears as a brownish red, raised, scaly, indurated plaque with well-defined borders, which may ulcerate at its center. When lesions appear on the glans penis, it’s called Queyrat’s erythroplasia.
Candidiasis
When candidiasis involves the anogenital area, it produces erythematous, weepy, circumscribed lesions that usually appear under the prepuce. Vesicles and pustules may also develop.
Chancroid
Chancroid is an STD that’s characterized by the eruption of one or more lesions, usually on the groin, inner thigh, or penis. Within 24 hours, the lesion changes from a reddened area to a small papule. (A similar papule may erupt on the tongue, lip, breast, or umbilicus.) It then becomes an inflamed pustule that rapidly ulcerates. This painful — and usually deep — ulcer bleeds easily and often has a purulent gray or yellow exudate covering its base. Rarely more than ¾";(2 cm) in diameter, it’s typically irregular in shape. The inguinal lymph nodes also enlarge, become very tender, and may drain pus.
Folliculitis and furunculosis
Folliculitis (hair follicle infection) may cause red, sharply pointed lesions that are tender and swollen with central pustules. If folliculitis progresses to furunculosis, these lesions become hard, painful nodules that may gradually enlarge and rupture, discharging pus and necrotic material. Rupture relieves the pain, but erythema and edema may persist for days or weeks.
Genital herpes
An STD, genital herpes produces fluid-filled vesicles on the glans penis, foreskin, or penile shaft and, occasionally, on the mouth or anus. Usually painless at first, these vesicles may rupture and become extensive, shallow, painful ulcers accompanied by redness, marked edema, and tender, inguinal lymph nodes. Other findings may include fever, malaise, and dysuria. If the vesicles recur in the same area, the patient usually feels localized numbness and tingling before they erupt. Associated inflammation is typically less marked.
Genital warts
Most common in sexually active males, genital warts initially develop on the subpreputial sac or urethral meatus (less commonly, on the penile shaft); they then spread to the perineum and the perianal area. These painless warts start as tiny red or pink swellings that may grow to 4";(10.2 cm) and become pedunculated. Multiple swellings are common, giving the warts a cauliflower appearance. Infected warts are also malodorous.
Lichen planus
With lichen planus, small, polygonal, violet papules develop on the glans penis. These papules are shiny and less than 1¼";(3.2 cm) in diameter and have white, lacy, milky striations. They may be linear or coalesce into plaques. Occasionally, oral lesions precede genital lesions. Also, lesions may affect the lower back, ankles, and lower legs. Accompanying findings may include pruritus, distorted nails, and alopecia.
Pediculosis pubis
Pediculosis pubis, a parasitic infestation, is characterized by erythematous, itching papules in the pubic area and around the anus, abdomen, and thigh. Inspection may detect grayish white specks (lice eggs) attached to hair shafts. Skin irritation from scratching in these areas is common.
Psoriasis
With psoriasis, red, raised, scaly plaques typically affect the scalp, chest, knees, elbows, and lower back. When they occur on the groin or on the shaft and glans of the penis, the plaques are usually redder; on an uncircumcised penis, the characteristic silver scales are absent. The patient commonly reports itching; pain from dry, cracked, encrusted lesions occasionally occurs. Nail pitting and joint stiffness may also occur.
Scabies
Scabies are mites that burrow under the skin and may cause crusted lesions or large papules on the glans and shaft of the penis and on the scrotum. Lesions may also occur on the wrists, elbows, axillae, and waist. They’re usually raised, threadlike, ⅜" to 4";(1 to 10 cm) long, and have a swollen nodule or red papule that contains the mite. Nocturnal itching is typical and commonly causes excoriation.
Seborrheic dermatitis
Initially, seborrheic dermatitis causes erythematous, dry or moist greasy scaling papules, and yellow crusts that enlarge to form annular plaques. These itchy plaques may affect the glans and shaft of the penis, scrotum, and groin as well as the scalp, chest, eyebrows, back, axillae, and umbilicus.
Syphilis
Two to four weeks after exposure to the spirochete Treponema pallidum (syphilis), one or more primary lesions, or chancres, may erupt on the genitalia; occasionally, they also erupt elsewhere on the body, typically on the mouth or perianal area. The chancre usually starts as a small, red, fluid-filled papule and then erodes to form a painless, firm, indurated, shallow ulcer with a clear base and a scant, yellow serous discharge or, less commonly, a hard papule. This lesion gradually involutes and disappears. Painless, unilateral regional lymphadenopathy is also typical.
Tinea cruris
Also called jock itch, tinea cruris is a superficial fungal infection that usually causes sharply defined, slightly raised, scaling patches on the inner thigh or groin (often bilaterally) and, less commonly, on the scrotum and penis. Pruritus may be severe.
Urticaria
Urticaria is a common allergic reaction that’s characterized by intensely pruritic hives, which may appear on the genitalia, especially on the foreskin or shaft of the penis. These distinct, raised, evanescent wheals are surrounded by an erythematous flare.
Other causes
Drugs
Phenolphthalein, barbiturates, and certain broad-spectrum antibiotics, such as tetracycline and sulfonamides, may cause a fixed drug eruption and a genital lesion.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Genital lesions, male:
Medical causes
(Nursing: Interpreting Signs and Symptoms)
Balanitis and balanoposthitis.Typically, balanitis (glans infection) and posthitis (prepuce infection) occur together (balanoposthitis), causing painful ulceration on the glans, foreskin, or penile shaft. Ulceration is usually preceded by 2 to 3 days of prepuce irritation and soreness, followed by a foul discharge and edema. The patient may then develop features of acute infection, such as a fever with chills, malaise, and dysuria. Without treatment, the ulcers may deepen and multiply. Eventually, the entire penis and scrotum may become gangrenous, resulting in life-threatening sepsis.
Bowen's disease.Bowen's disease is a painless, premalignant lesion that commonly occurs on the penis or scrotum, but may also appear elsewhere. It appears as a brownish red, raised, scaly, indurated plaque with well-defined borders, which may ulcerate at its center.
Chancroid.Chancroid is an STD that's characterized by the eruption of one or more lesions, usually on the groin, inner thigh, or penis. Within 24 hours, the lesion changes from a reddened area to a small papule. (A similar papule may erupt on the tongue, lip, breast, or umbilicus.) It then becomes an inflamed pustule that rapidly ulcerates. This painful—and usually deep—ulcer bleeds easily and commonly has a purulent gray or yellow exudate covering its base. Rarely more than 2 cm in diameter, it's typically irregular in shape. The inguinal lymph nodes also enlarge, become very tender, and may drain pus.
Folliculitis and furunculosis.Hair follicle infection may cause red, sharply pointed lesions that are tender and swollen with central pustules. If folliculitis progresses to furunculosis, these lesions become hard, painful nodules that may gradually enlarge and rupture, discharging pus and necrotic material. Rupture relieves the pain, but erythema and edema may persist for days or weeks.
Genital herpes.Caused by herpesvirus type 1 or 2, genital herpes is an STD that produces fluid-filled vesicles on the glans penis, foreskin, or penile shaft and, occasionally, on the mouth or anus. Usually painless at first, these vesicles may rupture and become extensive, shallow, painful ulcers accompanied by redness, marked edema, and tender, inguinal lymph nodes. Other findings may include a fever, malaise, and dysuria. If the vesicles recur in the same area, the patient usually feels localized numbness and tingling before they erupt. Associated inflammation is typically less marked.
Genital warts.Most common in sexually active males, genital warts initially develop on the subpreputial sac or urethral meatus, and less commonly on the penile shaft; they then spread to the perineum and perianal area. These painless warts start as tiny red or pink swellings that may grow to 10.2 cm and become pedunculated. Multiple swellings are common, giving the warts a cauliflower appearance. Infected warts are also malodorous.
Leukoplakia.Leukoplakia is a precancerous disorder that's characterized by white, scaly patches on the glans and prepuce accompanied by skin thickening and occasionally fissures.
Pediculosis pubis.Pediculosis pubis is a parasitic infestation that's characterized by erythematous, itching papules in the pubic area and around the anus, abdomen, and thigh. Inspection may detect grayish white specks (lice eggs) attached to hair shafts. Skin irritation from scratching in these areas is common.
Penile cancer.Penile cancer usually produces a painless, enlarging wartlike lesion on the glans or foreskin. However, if the foreskin becomes unretractable, the patient may experience localized pain. Examination may reveal a foul-smelling discharge from the prepuce, a firm lump in the glans, and enlarged lymph nodes. Late signs and symptoms may include dysuria, pain, bleeding from the lesion, and urine retention and bladder distention associated with urinary tract obstruction.
Scabies.Mites that burrow under the skin in scabies may cause crusted lesions or large papules on the glans and shaft of the penis and on the scrotum. Lesions may also occur on the wrists, elbows, axillae, and waist. They're usually raised, threadlike, and 1 to 10 cm long and have a swollen nodule or red papule that contains the mite. Nocturnal itching is typical and commonly causes excoriation.
Syphilis.Two to four weeks after exposure to the spirochete Treponema pallidum, one or more primary lesions, or chancres, may erupt on the genitalia; occasionally, they also erupt elsewhere on the body, typically on the mouth or perianal area. The chancre usually starts as a small, red, fluid-filled papule and then erodes to form a painless, firm, indurated, shallow ulcer with a clear base and a scant, yellow serous discharge or, less commonly, a hard papule. This lesion gradually involutes and disappears. Painless, unilateral regional lymphadenopathy is also typical.
Tinea cruris.Also called jock itch, tinea cruris is a superficial fungal infection that usually causes sharply defined, slightly raised, scaling patches on the inner thigh or groin (typically bilaterally) and, less commonly, on the scrotum and penis. Pruritus may be severe.
Urticaria.Urticaria is a common allergic reaction that's characterized by intensely pruritic hives, which may appear on the genitalia, especially on the foreskin or shaft of the penis. These distinct, raised, evanescent wheals are surrounded by an erythematous flare.
Other causes
Drugs.Barbiturates, and certain broad-spectrum antibiotics, such as tetracycline and sulfonamides, may cause a fixed drug eruption and a genital lesion.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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