Rare and easily misdiagnosed, it should be noted. It is caused by infection with the subcutaneous nodule bacillus. Routes of infection: (1) Direct contact: such as during sexual intercourse when the penis comes into contact with a vagina or cervix affected by subcutaneous nodule sexually transmitted disease. It mainly occurs on the glans penis and near the external urethral orifice. (2) Most cases are secondary to pulmonary subcutaneous nodules, spreading to the corpus cavernosum of the penis via the bloodstream. (3) Severe urethral subcutaneous nodules may ulcerate and spread directly to involve the penis, potentially forming fistulas.

bubble_chart Clinical Manifestations

The clinical manifestations include a history of urinary frequency and hematuria secondary to urogenital subcutaneous nodules. The lesions begin at the glans penis, frenulum, coronal sulcus, and other areas. The initial stage [first stage] presents as a hard nodule the size of a mung bean, with surrounding swelling and hardening, no pain, gradually forming an ulcer with an irregular shape, infiltrative edges, and a surface covered with purulent exudate that is difficult to remove, without tenderness. The erythrocyte sedimentation rate is elevated. The Wassermann reaction is negative.

bubble_chart Diagnosis

Pathological examination of the lesion can confirm the diagnosis, but it should be differentiated from soft chancre, hard chancre, erosive or gangrenous balanitis, and early carcinoma of the penis.

bubble_chart Treatment Measures

Treatment involves antituberculosis drugs, local application of streptomycin solution for ulcers, and if necessary, seasonal epidemic lesion clearance or partial penectomy.