Figure 1

Figure 2

Figure 3

Tables at a glance

Table 1

Table 2

FIGURE 1

Figure 1: The lesion on initial presentation

FIGURE 2

Figure 2: Complete resolution of the lesion following surgical resection

FIGURE 3

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)

Table 1

Case	Age	Sex	Clinical Manifestation	Distribution	Diagnosis	Treatment of LCV	Response to treatment
Cam et al (5)	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

Table 2

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

Table 2: Erythema Elevatum Diutinum involving Penis.