Glans penis ulceration revealing Wegener's granulomatosis.

摘要

Wegener's granulomatosis (WG) is a necrotizing granuloma-tous vasculitis, responsible for mucocutaneous and systemic manifestations. Dermatological signs of the disease are dominated by purpura while prognosis of the disease depends on upper airway, lung and kidney involvement. Two cases with penile involvement of WG are reported in this issue. We report herein our experience about a third patient who developed isolated genital ulcerations, revealing the disease. A 50-year-old healthy man presented with a 3-month history of two painful penile ulcerations resistant to penicillin. The ulcerations measured 2.5 cm in diameter and extended from the edge of the glans to the meatus with raised margins. Complete physical examination was otherwise normal. Histopathological examination of a penile biopsy showed pseudoepitheliomatous hyperplasia, a perivascular and inflammatory dermal infiltrate containing a majority of polynuclear neutrophils with some mul-tinucleated histiocytes. These features were consistent with an infectious disease or a neutrophilic dermatosis (fig. 1). A search for sexually transmitted diseases, infectious and immunological assessments, including anti-neutrophil cytoplasmic antibodies (ANCAs), was negative.