A 32-year-old man presented with verrucous lesions on his glans penis. He had a history of paraplegia and neurogenic bladder, which resulted from a motor vehicle crash 9 years earlier. He was supposed to use an indwelling urinary catheter because of his neurogenic bladder. For the past 2 years, he instead used an external plastic bag that was tied with a rope to his penis. He noticed gradually enlarging multiple verrucous penile papules and nodules approximately 6 months after he began using the plastic bag (Figure 1). The lesions were malodorous but painless. Bacteriologic cultures of a swab from the lesional skin were negative for organisms. The clinical diagnosis was that of a genital wart infection. However, repeated polymerase chain reaction tests were negative for human papillomavirus infection. A punch biopsy specimen was obtained from a penile verrucous lesion and sent for microscopic examination (Figure 2 and Figure 3).
Kirtak N, İnalöz HS, Özgöztaşi O, Erbağci Z. Verrucous Penile Lesions on a Man With Paraplegia. Arch Dermatol. 2001;137(8):1095-1100. doi: