TABLE 10-1 ■ Abnormalities of the Penis
Hypospadias is a congenital displacement of the urethral meatus to the inferior surface of the penis. A groove extends from the actual urethral meatus to its normal location on the tip of the glans.
In Peyronie's disease, there are palpable nontender hard plaques just beneath the skin, usually along the dorsum of the penis. The patient complains of crooked, painful erections.
Venereal warts are rapidly growing excrescences that are moist and often malodorous. They result from infection by human papillomavirus.
A cluster of small vesicles, followed by shallow, painful, nonindurated ulcers on red bases, suggests a herpes simplex infection. The lesions may occur anywhere on the penis. Usually there are fewer lesions when the infection recurs.
A syphilitic chancre usually appears as an oval or round, dark red, painless erosion or ulcer with an indurated base. Nontender enlarged inguinal lymph nodes are typically associated. Chancres may be multiple, and when secondarily infected may be painful. They may then be mistaken for the lesions of herpes. Chancres are infectious.
Carcinoma may appear as an indurated nodule or ulcer that is usually nontender. Limited almost completely to men who are not circumcised in childhood, it may be masked by the prepuce. Any persistent penile sore must be considered suspicious.
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