Ulcerated Lesion on Glans Penis: A Case of Ulcus Durum Mimicking Squamous Cell Carcinoma

What is it about?

A 50-year-old man presented with a broad ulcerated lesion on the glans penis that persisted for 3 weeks. It was initially treated with various topicals by a dermatologist, but the ulcer persisted. The patient was referred to a department for diagnostic re-evaluation. The ulcer was highly suspicious for squamous cell carcinoma. Physical examination showed no signs of malignancy, and a biopsy was performed. The histological evaluation revealed an ulcer with a dense lymphoplasmacellular infiltrate and showed no hints for malignancy. The patient tested positive for Neisseria gonorrheae (NG) via PCR, and treatment was performed with a single intravenous injection of ceftriaxon 1 g. The patient was screened for other relevant STIs, and hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV were excluded via repeated serology. The patient was informed to abstain from any sexual contact until the complete healing of the ulcer. A control visit for a test of cure (TOC) after 1 month was performed and was negative.

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Why is it important?

The research is important because it highlights the need for healthcare professionals to consider syphilis as a possible cause of genital ulcers, especially those of sudden onset, as the incidence of the disease is on the rise globally. The case report also emphasizes the importance of screening for other STIs in patients presenting with genital ulcers, as the patient in this case had both syphilis and gonorrhea. The case report provides valuable information on the clinical presentation, diagnosis, and treatment of syphilis, which can help healthcare professionals to improve their management of patients with this disease. Key Takeaways: 1. Syphilis is a systemic but curable disease caused by the bacterium Treponema pallidum. 2. The incidence of syphilis is on the rise globally, with over 35,000 cases reported in Europe in 2019. 3. Genital ulcers, especially those of sudden onset, should be considered suspicious for syphilis, and patients should be screened for other STIs. 4. The patient in this case report had both syphilis and gonorrhea, highlighting the importance of screening for other STIs in patients presenting with genital ulcers. 5. Penicillin is the preferred treatment option for syphilis, and control visits should be performed to ensure the patient has fully recovered from the disease.