Case Number : Case 1089 - 26th August Posted By: Guest

The lesion represent vasculopathic process. Clinical correlation suggests developing gonococcal septicemia.

Difficult case. I´m having trouble associating the infectious process of the glans penis and the foot ulcer. My first thought is that this is not an infectious process, but an ulcer on glans penis and foot caused by Beçhet disease. My second opinion is an infectious emboli to the foot of an unknow infectious agent from the penis.

Despite acral pustules be common in gonococcemia, case history mentions an infectious process on the glans penis, but not an urethritis, which is the major manifestation of gonococcal infection in men. Furthermore, arthritis was not reported.
Images may represent patergic phenomenon of Behçet's disease, but this hypothesis also have its problems. Genital ulcerations are not common on glans, but scrotal involvement is typical. And [url="https://dermpathpro.com/index.html/_/latest-news/the-new-proposed-criteria-for-behcet%E2%80%99s-disease-r55"]other clinical findings[/url] of Behçet's disease were not mentioned.
On the other hand, diseases do not use to read medical books, and the two above hypotheses are valid.

We called this a vasculopathic process, possibly an embolus from the penile infection. We could not grow any organisms from either site and special stains were negative. I thought this was a nice example of wedge shaped necrosis that one can see from an embolic process. Behcet's disease is an excellent thought but did not fit clinically.