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Painless non-itching yellow-white spots on genital mucosa

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c118 (Published 11 February 2010) Cite this as: BMJ 2010;340:c118
  1. Matthias Möhrenschlager, dermatologist1,
  2. Reinhard Engst, professor of dermatology2,
  3. Johannes Ring, professor of dermatology2
  1. 1Department of Dermatology and Allergology, Hochgebirgsklinik, CH-7265 Davos, Switzerland
  2. 2Division Environmental Dermatology and Allergology GSF/TUM, Department of Dermatology and Allergy Biederstein, Technical University of Munich, D-80802 Munich, Germany
  1. Correspondence to: M Möhrenschlager matthias.moehrenschlager{at}hgk.ch

    A 28 year old white man presented to the dermatology clinic because of raised, yellow-white coloured skin lesions on the glans of his penis that had been increasing in number over two years. Repeated attempts had been made to cure the affected areas with topical antimycotic drugs, antibiotics, and virostatic agents.

    Macroscopic inspection showed a penile mucosa covered by densely aggregated yellow-white, minute papules (figure). Lesional swabs to look for colonisation with bacteria, fungi, or viruses were unremarkable.

    Questions

    • 1 What is the likely diagnosis?

    • 2 What is the causative pathological mechanism?

    • 3 What treatment …

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