Balanitis in Acute Lymphoblastic Leukemia: A Rare Etiology and Unusual Presentation

Excerpt

An 18-year-old virgin boy, belonging to a poor socio-economic background and a diagnosed case of acute lymphoblastic leukemia on induction chemotherapy (Day-25), presented with painful swelling of glans penis with nocturnal exacerbation. He was afebrile. He had history of circumcision during early infancy. Examination revealed stark balanitis along with erythematous, scaly, papular lesions on penile shaft, scrotal skin, trunk, and bilateral upper and lower limbs (Fig. 1a, b). Web spaces of hands and feet were uninvolved and pruritus was minimal. The family members gave history of pruritic skin lesions. A possibility of scabies was considered and he was treated with topical 5% permethrin and single dose of ivermectin. Within days there was significant improvement in balanitis and papular rash (Fig. 1c, d). The oral and topical treatment was repeated after 1 week and family members were also treated appropriately. He never developed similar skin lesions later during chemotherapy.

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