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April 1989

Persistent Genital Ulceration

Author Affiliations

The Johns Hopkins Hospital, Baltimore, Md

Arch Dermatol. 1989;125(4):553-554. doi:10.1001/archderm.1989.01670160101021

REPORT OF A CASE  A 29-year-old man presented to a local physician for evaluation of a penile ulcer that had been present for 2 weeks. The patient was treated with tetracycline for 2 weeks followed by doxycycline calcium for 2 weeks without improvement. A surgical excision was performed, and there was dehiscence of the wound with a resultant persistent painful ulceration. He was referred to our dermatology clinic for further evaluation and treatment.The patient denied a history of sexually transmitted diseases, specifically, genital ulcers. He also denied fevers, chills, or malaise associated with the present problem. Physical examination showed a solitary indurated 2.4-cm tender lesion on the glans penis with a purulent ulcerated base (Fig 1). He had bilateral inguinal adenopathy. The remainder of the mucocutaneous examination was within normal limits.A smear was taken from the undermined border of the ulcer and stained with Wright's, Giemsa, and Gram's