Clinical features

Clinical features

Many patients present late as a fungating/ulcerative growth ( Figure 85.24 ), either because of embarrassment or because of misdiagnosis. About 10% of patients are under 40 years of age. By the time the patient presents, the growth is often large and secondary infection causes a foul, bloody discharge. There is typically little or no pain. Around 50% have inguinal lymph node enlargement at presentation but the nodal enlargement often reflects infection. In many , the prepuce is non-retractile and must be split to view the lesion. A biopsy should be performed to make the diagno - sis. Untreated, the w hole glans may be replaced by a fungating o ff ensive mass. Later, the inguinal nodes can erode the skin of the groin and, in rar e cases, death of the patient can result from erosion of the femoral or external iliac vessels.