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Painful penile ulceration in a patient with malignant atrophic papulosis

K Aydogan1, G Alkan, S Karadogan Koran

  • 1Department of Dermatology, Uludag University School of Medicine, Bursa, Turkey.

Journal of the European Academy of Dermatology and Venereology : JEADV
|September 17, 2005
PubMed

Insights

Malignant atrophic papulosis (MAP) is a rare vasculopathy. This case highlights a rare penile ulceration and esophageal fistula in MAP, with limited treatment options and a poor prognosis.

Area of Science:

  • Vascular Medicine
  • Rare Diseases
  • Dermatology

Background:

  • Malignant atrophic papulosis (MAP) is a rare obliterating vasculopathy with high mortality.
  • Systemic involvement is common, though genital presentation is exceptionally rare.
  • Understanding MAP pathogenesis and effective treatments remains challenging.

Observation:

  • A 45-year-old male presented with multisystemic MAP, including painful penile ulceration.
  • This represents the second reported case of MAP with penile involvement.
  • The patient developed an esophageal fistula, a previously unreported complication of MAP.

Findings:

  • The combination therapy of pentoxifylline and dipyridamole showed no benefit in halting disease progression.
  • The patient succumbed to intestinal and intrathoracic manifestations of MAP.
  • The efficacy of pentoxifylline, a potential treatment, could not be confirmed in this case.

Implications:

  • This case underscores the rarity of genital involvement in MAP and introduces esophageal fistula as a new complication.
  • It questions the efficacy of pentoxifylline in managing advanced MAP.
  • Further research is needed to elucidate MAP pathogenesis and develop effective therapeutic strategies for this devastating disease.

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