Penile gangrene as a sign of uncontrolled diabetes mellitus

Description

A 33-year-old African-American man with a previous medical history of type II diabetes mellitus and tobacco abuse presented to our outpatient clinic because of a penile lesion. The lesion started 1 month prior to presentation. The patient reported a history of minor injury while zipping his pants, which resulted in slight redness at the tip of his glans penis, progressing to blackish discolouration. He was sexually active with one female partner and reported infrequent oral sex. He had no penile discharge, no pain and no urinary symptoms.

His diabetes mellitus was diagnosed 3 years prior to presentation. He was non-compliant with oral hypoglycaemic medications. Examination showed normal vital signs and superficial dry gangrene with no drainage (figure 1). He had no inguinal lymphadenopathy. The reminder of his physical examination, including cardiovascular examination, was normal. Lab investigations showed haemoglobin A1c of 12.9% (reference 0–5.7%). Comprehensive metabolic panel, complete...

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