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To the Editor:
—In reply to the note of Dr. Donovan, I would say that I appreciate his calling my attention to the fact that erosive and gangrenous balanitis has been spoken of as the fourth venereal disease; in fact, I have already used this term, I am afraid, with my students in the past. It seems to me, however, that erosive and gangrenous balanitis will never assume the prominent position that lymphogranuloma inguinale has already taken.In the first place, the average case of erosive and gangrenous balanitis is comparatively benign, if a correct diagnosis is made and if the proper type of measures is used, including the use of oxidizing agents, for example, potassium permanganate or hydrogen peroxide and, exposing the infected area to the open air.Moreover, erosive and gangrenous balanitis is a far rarer disease than is lymphogranuloma inguinale, and finally the prognosis of an erosive
Cole HN. THE FOURTH VENEREAL DISEASE. JAMA. 1933;101(22):1744. doi:10.1001/jama.1933.02740470058029
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