Journal of Cutaneous and Aesthetic Surgery
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EDITORIAL COMMENT Table of Contents   
Year : 2010  |  Volume : 3  |  Issue : 1  |  Page : 44
Editorial Comment


Mansoura Faculty of Medicine, General Surgery Department, Mansoura University, Egypt

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Date of Web Publication15-May-2010
 

How to cite this article:
Ghnnam WM. Editorial Comment. J Cutan Aesthet Surg 2010;3:44

How to cite this URL:
Ghnnam WM. Editorial Comment. J Cutan Aesthet Surg [serial online] 2010 [cited 2019 Aug 18];3:44. Available from: http://www.jcasonline.com/text.asp?2010/3/1/44/63397


Fournier's gangrene (FG) is a fulminant form of infective necrotizing fasciitis of the perineal, genital, or perianal regions, which commonly affects men, but can also occur in women and children. Though first described by Fournier in 1883 as an idiopathic condition, in most cases a perianal infection, urinary tract infection and local trauma, or a cutaneous source can be identified. It is rapidly progressive and therefore needs immediate and aggressive management. Surgical debridement must be extensive and, if necessary, serial. Even with the aggressive surgical and medical treatment, mortality of the disease is still high.[1]

The localized involvement of penis alone, as reported in the presented case is rare.

An important differential diagnosis for such localized involvement is pyoderma gangrenosum affecting the penile skin, which may show a similar presentation as Fournier's gangrene. Prompt and early diagnosis is of vital importance as effective management for each process is markedly different.[2],[3]

The following questionnaire is helpful in arriving at a diagnosis of penile FG:

  1. Is there a felt crepitus underneath the penile skin or presence of air demonstrated by MRI in the genital or perineal area?
  2. Is the aetiology polymicrobial?
  3. Is there any response to surgical treatment and antibiotics?
  4. Have the following causes of gangrenous ulcerations of the penis like, sexually transmitted diseases, multi-system disease (e.g., Behcet's), necrotizing fascitis, cutaneous metastatic Crohn's disease, deep fungal infection, pemphigus vegetans, neoplastic conditions, erosive lichen planus, trauma, and factitious damage, been excluded?


 
   References Top

1.Ghnnam WM. Fournier's gangrene in Mansoura Egypt: A review of 74 cases. J Postgrad Med 2008;54:106-9.  Back to cited text no. 1  [PUBMED]  Medknow Journal  
2.Kohjimoto Y, Inagaki T, Iba A, Kikkawa K, Suzuki A, Uekado Y, et al. Pyoderma gangrenosum of the penis presenting as Fournier's gangrene: A case report. Hinyokika Kiyo 2005;51:411-5.  Back to cited text no. 2  [PUBMED]    
3.Talwar A, Puri N, Singh M. Fournier's gangrene of the penis: A rare entity. J Cutan Aesthet Surg 2010:3:41-3.  Back to cited text no. 3      

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Correspondence Address:
Wagih Mommtaz Ghnnam
14 Gawad Hosney Street, Sherbin, Dakahlia
Egypt
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Source of Support: None, Conflict of Interest: None


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