Penile necrosis secondary to purpura fulminans: a case report and review of literature

Abstract

We report the case of a 60-year-old Hispanic male with widespread necrotic purpuric lesions involving the penile, suprapubic, inguinal and hip dermis due to purpura fulminans. Purpura fulminans describes a rare syndrome involving intravascular thrombosis and hemorrhagic infarction of the skin; this rapidly progressing syndrome features vascular collapse and disseminated intravascular coagulation. This patient's penile necrosis involved the majority of the penile shaft and glans penis, and ultimately required partial glansectomy and repeated debridement for treatment. Subsequently, full thickness skin grafting was completed for reconstruction with good effect. While reports of penile necrosis secondary to various causes are documented in the literature, no prior reports describe penile necrosis secondary to purpura fulminans.

Figure 1:

Prior to surgical debridement.

Figure 2:

Following surgical debridement.

Figure 3:

Following full thickness skin grafting (dorsal aspect).

Figure 4:

Following full thickness skin grafting (ventral aspect).

Figure 5:

Outcome at 8 weeks follow-up.