Active secondary penile ulcers

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File Number:203007-8
Date of Image Capture:05/07/2022

Active secondary penile ulcers in a 30-year-old cisgender man with HMPX.

Located on the foreskin overlying the right side of the penile base is a round 10-mm nontender ulcer surrounded by resolving poorly demarcated erythema, imaged at lesion day 10. These lesions took 18 days to heal.

A second lesion is incompletely visualized on the underside of the penile shaft, imaged at lesion day 9.

These ulcers are associated with tender bilateral inguinal lymphadenopathy and a faint suprapubic maculopapular rash. This was mistaken for syphilis, for which he received treatment empirically, prior to receiving the diagnosis of HMPX.

There was no history of immunocompromising conditions or medications. This man was on Truvada for HIV pre-exposure prophylaxis. He also received Imvamune for HMPX pre-exposure prophylaxis 3 days before illness onset.


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