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Painful penile ulceration in a patient with malignant atrophic papulosis.
[malignant atrophic papulosis]
Malignant
atrophic
papulosis
(
MAP
)
is
a
rare
,
obliterating
vasculopathy
affecting
multiple
systems
,
frequently
with
a
poor
prognosis
.
Although
cutaneous
lesions
are
often
the
initial
presentation
,
systemic
involvement
is
also
common
,
usually
with
a
fatal
outcome
.
Involvement
of
the
genitalia
is
very
rare
.
We
describe
a
45
-
year
-old
male
patient
with
multisytemic
manifestation
of
MAP
accompanied
by
painful
penile
ulceration
.
The
pathogenesis
of
MAP
is
not
yet
fully
understood
and
effective
treatment
choices
are
limited
.
In
our
case
,
the
combination
of
pentoxifylline
and
dipyridamole
failed
to
provide
a
beneficial
effect
on
the
progression
of
the
disease
and
the
patient
died
due
to
intestinal
and
intrathoracic
manifestation
of
MAP
.
In
the
present
case
,
attention
should
be
drawn
to
the
following
clinical
course
and
therapeutic
properties
:
(
i
)
we
describe
the
second
patient
in
the
literature
diagnosed
with
MAP
and
painful
penile
ulceration
;
(
ii
)
to
our
knowledge
,
this
is
the
first
reported
case
with
oesophageal
fistula
due
to
MAP
;
(
iii
)
we
could
not
confirm
the
efficacy
of
pentoxifylline
,
the
recently
reported
treatment
modality
,
in
our
patient
.
Diseases
Validation
Diseases presenting
"intestinal"
symptom
malignant atrophic papulosis
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