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Year : 2000  |  Volume : 16  |  Issue : 2  |  Page : 165-166

Spontaneous penile skin gangrene in AIDS

Department of Genito-Urinary Surgery, Osmania General Hospital, Hyderabad, India

Correspondence Address:
Mallikarjuna N Reddy
Department of Genito-Urinary Surgery, Osmania General Hospital, Hyderabad, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

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AIDS is a systematic infection of retrovirus causing immunodeficiency. Many varied manifestations of the dis苟ase have been reported. Systemic vasculitis has been re計orted in as one of the manifestations of the syndrome. This has resulted in areas of skin necrosis in varied parts of 'the body. We report a case of penile skin necrosis which occurred spontaneously in a 25-year-old male patient with no evidence of trauma or infection.

Keywords: Penis; AIDS; Gangrene.

How to cite this article:
Reddy MN, Thyagi A, Sharma D, VSNL, Goud EK. Spontaneous penile skin gangrene in AIDS. Indian J Urol 2000;16:165-6

How to cite this URL:
Reddy MN, Thyagi A, Sharma D, VSNL, Goud EK. Spontaneous penile skin gangrene in AIDS. Indian J Urol [serial online] 2000 [cited 2023 Mar 24];16:165-6. Available from:

   Introduction Top

Presence of skin necrosis has been documented in AIDS. The cause was attributed to vasculitis or anti-phospholi計id antibodies in the serum. None of them have reported spontaneous penile skin necrosis. Most of the spontane觔us penile skin necroses were a part of Fournier's gan茆rene.

   Case Report Top

A 25-year-old male patient presented to our outpatient department with loss of the skin over the penis. There was no history of trauma or in terms of sexual activity or ap計lication of tourniquet or any erogenous devices. He had developed generalized lymphadenopathy and presented with black skin hanging loose from the penis and the pe要is having slough on the exposed surface [Figure 1]. There was no foul smell suggestive of infection and the patient was voiding normally from the urethra. Investigations of the patient showed that his renal parameters and the blood counts to be under normal limits. His CD4 counts were <200 cells/cumm, he was positive for western blot for AIDS. Urine culture was sterile. Slough over the penis and the sloughed skin did not grow any organisms on both aerobic and anaerobic cultures. Histopathology of the sloughed skin showed necrosis with minimal inflamma負ory infiltrate and no organisms were seen.

   Discussion Top

On exhaustive review of literature in the Internet there were no reports of spontaneous skin necrosis available. Cases of penile skin necrosis have been documented as part of Fournier's gangrene. Skin necrosis in AIDS was also reported by Soweid AM et al in South Med J and the cause for the necrosis was due to anti-phospholipid anti苑odies. Reports of penile calciphylaxis have been reported and the cause was tertiary hyperparathyroidism in chronic renal failure. 10 cases of distal penile gangrene was re計orted in patients with chronic renal failure. [1],[2],[3],[4],[5],[6] Cutaneous gangrene due to hyperparathyroidism secondary to chronic renal failure were reported. A case of penile necrosis with extensive Kaposi's sarcoma was reported by Klein et al. The presentation is surprisingly only skin involvement of the penile skin with no extension into the underlying tis貞ues with no evidence of trauma or infection.

   References Top

1.Stein M, Anderson C, Ricciardi R et al. Penile gangrene associated with chronic renal failure: report of 7 cases and review of the litera負ure. J Urol 1994; 152: 2014-2016.  Back to cited text no. 1    
2.Atalay AC, Karaman MI. Distal penile gangrene in a patient with chronic renal failure. Int J Urol 1997; 4: 431-432.  Back to cited text no. 2  [PUBMED]  
3.Jhaveri FM, Woosley JT, Fried FA. Penile calciphylaxis: rare necrotic lesions in chronic renal failure patients. J Urol 1998; 160: 764-767.  Back to cited text no. 3  [PUBMED]  
4.Wilkinson SP, Stewart WK, Parham DM, Guthrie W. Symmetric gangrene of the extremities in late renal failure: a case report and review of the literature. Q J Med 1988; 67: 319-341.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Soweid AM. Hajjar RR, Hewan-Lowe KO. Gonzalez EB. Skin necrosis indicating antiphospholipid syndrome in patient with AIDS. South Med J 1995; 88: 786-788.  Back to cited text no. 5    
6.Klein LT, Lowe FC. Penile gangrene associated with extensiveKaposi's sarcoma in patients with the acquired immunodeficiency syndrome. Urology 1995; 46: 425-428.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]


  [Figure 1]


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