Journal of Cutaneous and Aesthetic Surgery

EDITORIAL COMMENT
Year
: 2010  |  Volume : 3  |  Issue : 1  |  Page : 44-

Editorial Comment


Wagih Mommtaz Ghnnam 
 Mansoura Faculty of Medicine, General Surgery Department, Mansoura University, Egypt

Correspondence Address:
Wagih Mommtaz Ghnnam
14 Gawad Hosney Street, Sherbin, Dakahlia
Egypt




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


How to cite this URL:
Ghnnam WM. Editorial Comment. J Cutan Aesthet Surg [serial online] 2010 [cited 2021 Dec 8 ];3:44-44
Available from: https://www.jcasonline.com/text.asp?2010/3/1/44/63397


Full Text

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:

Is there a felt crepitus underneath the penile skin or presence of air demonstrated by MRI in the genital or perineal area?Is the aetiology polymicrobial?Is there any response to surgical treatment and antibiotics?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

1Ghnnam WM. Fournier's gangrene in Mansoura Egypt: A review of 74 cases. J Postgrad Med 2008;54:106-9.
2Kohjimoto 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.
3Talwar A, Puri N, Singh M. Fournier's gangrene of the penis: A rare entity. J Cutan Aesthet Surg 2010:3:41-3.