Department of Dermatology, University Hospital, Coventry, West Midlands, UK.
Department of Dermatology, Chelsea and Westminster Hospital, London, UK.
Clin Exp Dermatol. 2019 Jan;44(1):20-31. doi: 10.1111/ced.13609. Epub 2018 Jul 15.
Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential diagnosis. It creates significant physical and psychosexual morbidity, and presents considerable therapeutic challenges. The existing literature is limited.
To describe and share our updated cumulative experience of a cohort of patients with penile lymphoedema.
This was a retrospective review of the case records of patients with chronic penile lymphoedema seen in two dedicated male genital dermatology clinics between January 2011 and July 2016.
In total, 41 cases were identified. Over a third had Crohn disease (CD) (which was occult in one-third of these), and over a third had serological evidence of streptococcal infection. All patients responded to systemic antibiotics and specialized urological surgery circumcision and excision).
Penile lymphoedema should be investigated to exclude underlying pathology especially CD and streptococcal infection. Treatment with antibiotics should be considered early and long term to try to preserve the foreskin: most patients are uncircumcised. Some patients may benefit from a course or courses of oral steroids. The development of gross dysfunction of the prepuce usually dictates circumcision and excision of lymphoedematous tissue once the situation is medically stabilized.
阴茎淋巴水肿（伴或不伴蜂窝织炎）是一种罕见的、常为慢性的、临床表现多样且病因不明的疾病，具有重要的鉴别诊断意义。它会导致严重的身体和心理性性功能障碍，并带来相当大的治疗挑战。目前的文献有限。
描述和分享我们在两个专门的男性生殖器皮肤科诊所中，于 2011 年 1 月至 2016 年 7 月间治疗的一组慢性阴茎淋巴水肿患者的最新累积经验。
这是一项回顾性病例记录研究，纳入了在两个专门的男性生殖器皮肤科诊所中，于 2011 年 1 月至 2016 年 7 月间诊断为慢性阴茎淋巴水肿的患者。
共发现 41 例病例。超过三分之一的患者患有克罗恩病（CD）（其中三分之一的患者 CD 为隐匿性），超过三分之一的患者存在链球菌感染的血清学证据。所有患者均对全身性抗生素和专门的泌尿科手术（如包皮环切术和切除术）有反应。
应调查阴茎淋巴水肿以排除潜在的疾病，特别是 CD 和链球菌感染。应尽早并长期考虑使用抗生素进行治疗，以尝试保留包皮：大多数患者未行包皮环切术。一些患者可能受益于口服类固醇的疗程。一旦病情得到医学稳定，包皮的严重功能障碍通常需要行包皮环切术和切除淋巴水肿组织。
