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Can Fam Physician. 2010 December; 56(12): 1303.
PMCID: PMC3001925

Question: Can you identify this condition?

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A 38-year-old man was referred to our clinic with a 2-week history of painful lesions located on the penis. He had no past medical history for this event. During the first few days of onset, he had a fever (38.5ºC) without any other systemic symptoms. Treatment with ketoconazole cream and topical steroids had worsened the lesions. A physical examination revealed a number of small ulcers with a fibrin surface and a herpetiform distribution in the coronal sulcus and glans penis. Bilateral inguinal palpation revealed the presence of small and mobile lymph nodes. Tzanck test results showed multinucleated giant cells and epithelial cells containing eosinophilic intranuclear inclusion bodies. Laboratory workup included a hemogram and biochemistry and coagulation tests, which all had negative or normal results.

The most likely diagnosis is

  1. Primary syphilis
  2. Chancroid
  3. Reiter syndrome
  4. Genital herpes
  5. Behçet syndrome

Answer on page 1304


Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada