Nokea
Your 20 year old male patient is c/o growths on his penile shaft. He noticed them first about 6 weeks ago, and he thinks there are more now. Denies pain with intercourse or urination. He has had 3 former partners and has been with his current girlfriend for 6 months. She is on the pill so they do not use condoms. Denies fever, weight loss, night sweats. His PMH is unremarkable. He is in college part time and works in construction and is engaged to be married and has no children. On exam, you see several moist papules along all sides of the penile shaft and two on the corona. He has been circumcised. On palpation of his inguinal region there is no inguinal lymphadenopathy. Which abnormality of the penis does this patient most likely have?
Correct Answer: A
Rationale: The correct answer is A: Condylomata acuminata (genital warts) based on the patient's presentation of painless moist papules on the penile shaft and corona, multiple sexual partners, lack of other systemic symptoms, and absence of inguinal lymphadenopathy. This is consistent with HPV infection, the most likely cause of genital warts. Genital herpes (B) typically presents as painful vesicles or ulcers, syphilitic chancre (C) presents as a painless ulcer, and penile carcinoma (D) usually presents as a solitary, indurated, ulcerated lesion with associated lymphadenopathy.