By Gary M. White, MD
Rarely, a dermatitis of the penis can cause tremendous swelling. The lymphedema may be acute or chronic.
- Swelling from inflammation and/or lymphedema of the penis can be dramatic, sometimes making it look like a saxophone.
Edema of the penis can take on several forms. The most impressive is the pronounced enlargement and curvature of the so called saxophone penis. Acute penile enlargement may be from a variety of causes including:
- Infection, e.g., lymphogranuloma venereum, Staphylococcus aureus, and mycobacterial infection.
- Allergic contact dermatitis, e.g., to Rhus.
- Irritation and inflammation from imiquimod treatment [JAMADerm 2014;150;1370].
Chronic edema in children may be caused by filarial infection, Crohn's disease, or a vascular abnormality [J Pediatr Surg 2014;49:1647-51]. In adults, it may be caused by:
- Filarial infection
- Obesity [J Plast Reconstr Aesthet Surg 2014 Dec;67:1719-25]
- Hidradenitis suppurativa
- Post surgical
- Post radiation
- Crohn's disease
- Compulsive masturbation [Arch Sex Behav. 2012 Jun;41(3):737-9]
Filarial infection is perhaps the most common cause worldwide. Chronic lymphedema can lead to polypoid and verrucous lesions. Many adult patients with the chronic form are obese.
Treating the cause is, of course, paramount. In acute cases, the penis will return to normal once the inflammation has subsided. Prednisone may be given if the cause is primarily inflammatory and not infectious.
In chronic cases where there is no obvious cause, a search for a neoplasm or other blockage of the lymphatics is in order. Weight loss is important if the patient is overweight. Plastic surgery may be considered [J Plast Reconstr Aesthet Surg. 2014 Oct 23]. A compression device has been reported [Urol Ann. 2014;6:88-90].
Dramatic picture of saxophone penis. Indian Dermatol Online J 2015;6:462-3
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