A sexually active 45-year-old Hispanic male presented after falling out of a moving vehicle. The patient appeared to be in no acute distress, had a Glasgow Coma Score of 14, and smelled of alcohol. The primary survey did not reveal any obvious life-threatening injuries. The patient was complaining of occipital, right shoulder, and left lower leg pain. Visual examination of the genitourinary system revealed multiple 1-cm subcutaneous nodules diffusely spread around the circumference of the penile shaft (Figure l).The lesions were hard, nontender, and fixed to the underlying tissue. A Foley catheter was inserted to allow for strict monitoring of input and output.
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