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Penile ulcer: cause of genital ulcer found in elderly patient
With an ulcer on the penis, doctors usually quickly suspect an STD as the cause. Doctors in the skin disease clinic at the Jena University Hospital also thought that the patient who found them with a scabbed area on their limbs may have syphilis. But after a man's confession, they found another explanation.
Enigmatic patient at the Jena University Hospital
There can be various causes for an ulcer on the penis. Among other things, venereal diseases can cause a tumor to form on the male limb. Therefore, doctors in the skin disease clinic at the Jena University Hospital assumed that the patient who found them with a scabbed area on their limbs may have syphilis. But then they found another explanation.
Unexplained ulcer on the penis
"Spiegel Online" reports in a recent article about a 58-year-old patient who went to the skin disease clinic at the Jena University Hospital because he had had an ulcer on his penis for days.
The scabbed swelling didn't hurt him, but it scared him.
After an initial examination, the doctors found swelling of the lymph nodes in the groin area. Otherwise, the genital area appeared unremarkable.
The HIV-positive man also has a hepatitis C infection and suffers from Crohn's disease. Because of the inflammatory bowel disease, he had been operated on several times.
The patient also explained that years ago he contracted an STD, which, however, was completely healed after long antibiotic therapy.
Patient confesses to drug use
According to his own information, he had not had sexual intercourse since his HIV diagnosis, neither with his wife nor with any other person.
Nevertheless, the doctors around dermatologist and clinic director Peter Elsner suspected a syphilis infection.
Because the typical early symptoms of the disease, which is spreading rapidly in Germany, include lymph node swellings and painless ulcers on the genital organs - as in the 58-year-old.
When, after further blood tests, the doctors found that the patient had actually been infected with syphilis but had overcome the disease and the search for a herpes infection was unsuccessful, the doctors asked the man further questions about his sex life.
The latter finally confessed that he had recently been to an anonymous sex party to have sex with men. There was also experimentation with drugs, including crystal meth.
Health risks from fashion drug
The drug has spread more and more in Germany in recent years:
"In today's performance society, the use of methamphetamine - called" crystal meth "due to its crystalline appearance - appears to be increasing," writes the Federal Center for Health Education (BZgA) on its website.
"It promises to manage stress and pressure with ease and, moreover, to be able to perform more quickly."
But especially in connection with the drug discovery by the Green Bundestag member Volker Beck, there was an increasing amount of information about how health-threatening crystal meth really is.
After the intoxication there is often a lack of motivation, sleep disorders, anxiety and depression. Therefore, consumers often take additional drugs or increase the dose.
In addition, the fashion drug threatens health problems such as rapid heartbeat, sweating, muscle cramps and dizziness as well as long-term physical effects such as brain damage, circulatory disorders, tooth loss, chronic skin inflammation ("crystal acne") or kidney and liver damage.
Psychological dependence is particularly dangerous, which can lead to anxiety and panic attacks, hallucinations, eating disorders and an increased risk of suicide.
Patient wanted to avoid visible puncture sites
The drug is usually sniffed as a powder. However, some consumers swallow them as tablets, smoke or inject them.
The patient at the Clinic for Skin Diseases at the Jena University Hospital also injected himself with the intoxicant. In his penis shaft, because he feared that the injection site could be seen when the arm was injected.
A short time later his limb swelled and he had to go to the hospital. After diagnosis, his wound was cleaned daily with disinfectants and an iodine-containing ointment. After two weeks the ulcer had healed completely.
In the "Journal of the German Society of Dermatology" (JDDG), the Jena experts report on the unusual case.
The article "Genital ulcer on the penis of a 58-year-old HIV-positive patient after local injection of methamphetamine (crystal meth)" can be downloaded there for a fee.
According to "Spiegel Online", Peter Elsner said: "Chem sex is increasing significantly."
Sexual intercourse under the influence of drugs is associated with numerous health risks. For example, heart disorders and psychoses are at risk.
It is also dangerous if the substances are injected into the genital organs. "The motivation is the stimulation in the genital area," explained Elsner. "But since the substance has a central nervous effect, this should be a myth." (Ad)