
Figure 1: The lesion on initial presentation
Figure 1: The lesion on initial presentation
Figure 2: Complete resolution of the lesion following surgical resection
Figure 3: Supplemental Figure: The histologic examination reveals fibrosis of the dermis (Figure A), leukocytoclastic vasculitis with fibrin deposition in the vessel walls (Figure B, arrow), extravasation of red blood cells (Figure C). The adjacent skin demonstrates a bandlike lymphoplasmacytic infiltrate along the dermal-epidermal junction and hyalinisation of the papillary dermis (arrow), consistent with balanitis xerotica obliterans (Figure D)
Case |
Age |
Sex |
Clinical Manifestation |
Distribution |
Diagnosis |
Treatment of LCV |
Response to treatment |
Cam et al |
45 days old |
Male |
Papular-purpuric and vesiculo-hemorrhagic lesions |
Palms and soles initially, spreading to arms, legs, and face |
Congenital syphilis |
Penicillin G for 15 days |
Resolved after 2 weeks |
Chao et al (6) |
74 |
Male |
Palpable skin rash 5-10 mm in size |
Right lower leg initially, spreading to the trunk and all 4 extremities including palms |
Secondary syphilis |
Penicillin G IV |
Resolved after 2 weeks |
Kim et al (7) |
46 |
Male |
Multiple painless round painless erythematous eroded papules |
Glans penis |
Primary syphilis |
Benzathine Penicillin G IV |
Resolved |
Furlan et al (8) |
37 |
Male |
Pink macules |
Upper trunk and upper limb joints |
Secondary syphilis |
Ceftriaxone 2g/day for 14 days |
Resolved within weeks |
Li at al (9) |
22 |
Male |
Palpable purpura and petechiae |
Lower legs, ankles, and dorsum of feet |
Secondary syphilis |
Oral prednisone for 3 days followed by Benzathine Penicillin IM for 3 weeks |
Resolved after 6 weeks |
Table 1:Patients with Leukocytoclastic Vasculitis (LCV) and Syphilis
Case |
Age |
Penile Manifestation |
Other site involvements |
Mizumoto et al (10)
Wahl et al (11)
Yoshii et al (12)
Ziemer et al (13)
Syuto et al (14)
Harbjerg et al (15) Current case |
59
55
74
68
64
67 70 |
Verruciform nodules on glans penis
2 cm hypopigmented, eroded, indurated plaque on the glans penis 3 x4 cm ulcer involving glans, coronal sulcus, and prepuce 0.8 cm skin-colored indurated plaque on the glans penis Penile ulcers on the glans, foreskin, and penile shaft 1 cm indurated mass on the glans penis 0.7 cm painless raised whitish plaque on the glans penis
|
Head, trunk, extensor of lower extremities, and dorsal feet None
Knees, lower extremities, and feet
None
Extremities, buttock, and larynx
None None |
Table 2: Erythema Elevatum Diutinum involving Penis.
Tables at a glance