Infiltrative, ulcerative, and fistular lesions of the penis due to lymphogranuloma venereum.

Resurgence of Lymphogranuloma Venereum in Western Europe: An Outbreak ofChlamydia trachomatisSerovar L2Proctitis in The Netherlands among Men Who Have Sex with Men

“…To our knowledge, this is the first extensive description of a series of clinically observed LGV cases in the Western world. The best recognized presentation of LGV in the early phase is the inguinal syndrome, which is characterized by acute inguinal lymphadenitis with bubo formation, sometimes preceded by a solitary primary lesion (e.g., herpetiform ulcer, papule, or pustule) [4,8]. The other clinical presentation of LGV, the anogenitorectal syndrome, causes moderate to severe ulcerative proctocolitis, which can clinically and histopathologically resemble Crohn disease [15,16].…”

“…Untreated, the infection may lead to a chronic inflammatory process with the formation of fistulae and strictures. Chronic inflammation of the lymphatic vessels, progressive lymph edema, and sclerosing fibrosis may cause severe disfiguring conditions, such as genital elephantiasis and esthiomene [3,4]. Genotyping C. trachomatis by nested PCR and restriction fragment-length polymorphism (RFLP) allows a reliable diagnosis [5][6][7].…”

Saxophone penis revisited

“…4 Penoscrotal elephantiasis is rare, occurring in approximately 4% of the reported cases. 5 Progressive spread of the disease leads to chronic progressive lymphangitis, which in turn leads to chronic indurated oedema, and sclerosis of the underlying subcutaneous tissue. Many descriptive terminologies have been used for the appearance of the affected penis, such as 'ram horn penis' and 'saxophone penis', when the penis gets twisted along its long axis, giving it the appearance resembling a saxophone.…”

Re‐emergence of lymphogranuloma venereum

“…Forrester recently reported the case of a 26‐year‐old homosexual male with HIV who was treated for Crohn's disease for almost a year before a diagnosis of LGV was made 47 . The tertiary stage appears in chronic untreated patients and is characterized by the formation of ano‐rectal strictures, perirectal abscesses, genital elephantiasis and esthinomenes 48–50 . Penile deformities such as the saxophone penis may also occur (Kumaran et al .)…”