Dr Ashish Sharma at King George’s Medical University in Lucknow, India and colleagues have reported a case of Contact dermatitis and gangrene of the penis due to a condom. The case has appeared in BMJ Case Reports.
According to the history a 30 years old man reported at KGMC Hospital with complaints of swelling, pain and blackening of the skin of the Penis for last 3 days. The patient was non-diabetic and had no known drug allergies.
He was subjected to a series of tests, which also included tests to rule out sexually transmitted infections. The patient was diagnosed as a case of allergic contact dermatitis, and gangrene of the penis. His Patch tests confirmed the man was allergic to benzocaine and flagged no other allergies.
The patient had reportedly used a new brand of condoms that contained a topical medication, benzocaine which the doctors noted is used in extended-pleasure latex condoms for prolonging the duration of sexual intercourse and to decrease premature ejaculation.
It was unfortunate that his quest to get the most out of his sex life ended up backfiring in a horrible way when he suffered an all allergic reaction and penile gangrene as a result of it.
The patient was put on antiallergics and culture-specific parenteral antibiotics with multiple sessions of surgical debridement to reduce the swelling. In addition to this surgeon operated on his penis and performed a skin graft.
The treatment was carried out over the course of three weeks, and six months later he was “doing fine”, reporting “no sexual or urinary complaints”, doctors said in the BMJ.
The first case of a man suffering allergic contact dermatitis after using latex condoms was documented in 1996.Since then, the doctors said there have been just four cases reported.
Speaking to The Sun, Dr Sharma’s team added: “This is believed to be the first ever documented case of allergic contact dermatitis and subsequent penile gangrene due to a benzocaine-containing latex condom.”
It was in 1996 when the first case of a man suffering allergic contact dermatitis after using latex condoms was documented and since then doctors have seen just four cases being reported.
While rare, there are certain things that can make it more likely that a man will suffer penile gangrene.
The reporting of such cases is extremely rare due to feelings of shame and social stigma. It is important that treating clinicians take thorough medical history (especially about past allergic reactions) and perform patch tests with the baseline series/suspicious agent to make a definitive diagnosis in such cases. Early diagnosis and treatment including parenteral antibiotic, serial debridement and regular dressing are needed in case of evolving or established penile skin gangrene.
Carry Home Ponts –
Superficial penile gangrene secondary to irritant contact dermatitis can occur even in sexually active men with no history of previous hypersensitivity.
The benzocaine contact dermatitis due to use of latex condoms is an extremely rare clinical entity and the superimposed bacterial infection over contact dermatitis of the penis may rarely lead to penile skin gangrene.
Thorough medical history (especially about past allergic reactions), clinical examinations and patch tests with baseline series/suspicious agent are crucial to making a definitive diagnosis of genital contact dermatitis.
Early diagnosis and treatment including antibiotics and debridement are needed for successful management of penile skin gangrene.
For further reference log on to :
BMJ Case Reports 2018; doi:10.1136/bcr-2018-227351
Dr. Kamal Kant Kohli
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