Post-circumcision non-venereal sclerosing lymphangitis

A 22-year-old male presented with complaints of an asymptomatic cord-like swelling over the penis since six months.Although the lesion was painless, the appearance of the lesion worried him.e patient had a history of repeatedly retracting remnant foreskin (post circumcision) over the shaft of the penis.e patient was otherwise healthy and did not give any history of vigorous sexual activity, penile manipulation, penile or scrotal swellings, urethral discharge, genital ulcers, or prior lesions of similar nature.Examination revealed a single 1.5 mm wide non-tender skin-colored serpiginous cord-like induration on the lateral aspect of the penis just below the coronal sulcus [Figure 1a-c].ere were no signs of inflammation, and the overlying skin was normal and freely mobile.Routine hematological and urine investigations, as well as a screening test for sexually transmitted infections were negative.e close differential diagnosis for our patient is Mondor's disease which is characterized by an initial presentation of severe pain and erythema; in contrast, our patient had a chronic course of illness and was completely asymptomatic.On cutaneous examination, thrombophlebitis of the penis is usually seen on the dorsum of the penis with a thrombosed vessel adhered to the penile skin covering it.In contrast, non-venereal sclerosing lymphangitis will have a serpiginous morphology with freely mobile overlying skin. [1]e diagnosis of non-venereal sclerosing lymphangitis was considered in view of the distinct clinical appearance of painless serpiginous cord-like induration following circumcision. [2]e patient was advised to abstain from the habit of repeated retraction of remnant foreskin and was counseled about the self-limiting benign nature of the disease.www.cosmoderma.