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Oct 2011

Penile Paraffinoma Developing During Treatment With Pegylated Interferon Alfa-2a for Chronic Hepatitis C Virus Infection

Author Affiliations

Author Affiliations: Services de M édecine Interne (Dr Bachmeyer), Anatomopathologie (Dr Moguelet), H épatogastroent érologie (Dr Gombeaud), et Dermatologie (Drs Sbidian and Aractingi), Centre Hospitalier Universitaire de Tenon (Assistance Publique H ôpitaux), Paris, France.

Arch Dermatol. 2011;147(10):1232-1233. doi:10.1001/archdermatol.2011.292

A 30-year-old Bulgarian of Romani descent was suspected of having penile cellulitis in March 2010. His medical history was remarkable for the recent diagnosis of chronic hepatitis C virus infection (genotype 3) with normal aminotransaminase levels, a viral load of 4.8 log IU/mL, and no fibrosis on liver elastography (Fibroscan). In December 2009, treatment with oral ribavirin (400 mg/d) and subcutaneous pegylated interferon alfa-2a (180 μg/wk) was initiated in an attempt to obtain a definitive cure. A viral clearance was demonstrated 15 days later. On March 3, 2010, the patient presented with a painful swelling of the penis, with inguinal lymph nodes. The anti –hepatitis C virus treatment was discontinued. The combination of amoxicillin and clavulanic acid was administered but was only partially effective. On March 10, a surgical exploration was performed to rule out an underlying abscess. A gelatinous substance was found, and the histologic pattern was interpreted as a nonspecific inflammatory reaction without any pathogen. The patient was then referred to establish a diagnosis.