Penile conditions Quiz: Ace Your Exams
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A 56-year-old man presents to a urology clinic for evaluation of an ulcerated penile lesion. The lesion has been present on the glans of the penis for eight weeks. He completed a course of penicillin, doxycycline, and fluconazole without improvement of the lesion. Past medical history includes psoriasis treated with topical corticosteroids. The patient immigrated from Sri Lanka in his twenties and is unsure of his vaccination status. He has had multiple sexual partners and occasionally uses condoms for protection. Vitals are within normal limits. Physical examination demonstrates a circumcised penis with a 2-cm painless ulcer noted on the dorsal aspect of the glans without surrounding swelling or erythema. Several verrucous, cauliflower-like growths are also noted at the base of the penis. Bilateral inguinal lymphadenopathy is noted. Which of the following is the strongest risk factor predisposing this patient to the development of this ulcerative lesion?
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