What is Sclerosing Lymphangitis?
Sclerosing Lymphangitisis a rare dermatological condition localized to the penis. It is characterized by a cord like swelling throughout the circumference of the area just under the head of the penis. It occurs as a result of swelling of a lymph vessel having swelling. Sclerosing Lymphangitisis a rare skin condition in which a lymph vessel in the penis becomes swollen and hard.[1, 2]
Sclerosing Lymphangitis quite often is not reported by people. It normally occurs in men in their 20s or 30s. At times, skin erosions also occur. In most of the cases, Sclerosing Lymphangitis does not require any treatment and does not pose a health risk. It has been observed that Sclerosing Lymphangitis affects mostly sexually active males. However, there have been exceptions where a 60 year old sexually inactive man has also been diagnosed with Sclerosing Lymphangitis[1, 2].
What Causes Sclerosing Lymphangitis?
The root cause of Sclerosing Lymphangitis still remains a mystery. However, some experts believe that vigorous sexual activity and the trauma to the penis as a result of it may be a probable cause. The repeated trauma causes the lymph vessel to get blocked. The function of the lymph vessel is to transport white blood cells and lymphatic fluid around the lymphatic system[1, 2].
Some experts feel that circumcision is also one of the causative factors for Sclerosing Lymphangitis but further research is necessary to prove this argument. There is some data that suggests that sexually transmitted infections also have a role to play in Sclerosing Lymphangitis, especially syphilis[1, 2].
What are the Symptoms of Sclerosing Lymphangitis?
The primary symptom of Sclerosing Lymphangitisis a hard cord like swelling just beneath the head of the penis also called as coronal sulcus. It is often mistaken by people as a swollen vein but the difference here is that a swollen vein will be red or purple in color which is not the case in Sclerosing Lymphangitis. The swelling will be around 3 mm in width. The area will be hard to palpation and there is no pain on touching the affected area[2].
The swelling is visible both when the penis is erect and when it is flaccid. If sexually transmitted infections are to be blamed for Sclerosing Lymphangitis then the person will experience additional symptoms as seen with STIs as well[2].
How is Sclerosing Lymphangitis Diagnosed?
The diagnosis of Sclerosing Lymphangitisbegins with a careful examination of the affected area. The patient will be asked about his recent history as to whether he has been involved in vigorous sexual activity which may be a cause of the swelling. Additionally, the physician may order a swab test to look for any signs of a sexually transmitted infection. A urinalysis may also be performed for the same[2].
To look for any signs of an infection, a blood test will be done to check for elevated levels of white blood cell count. Once other conditions are ruled out, a Doppler ultrasound will be conducted which will confirmatively give a diagnosis of Sclerosing Lymphangitis[2].
How is Sclerosing Lymphangitis Treated?
Sclerosing Lymphangitisis a self-limiting condition and resolves spontaneously within a matter of four to six weeks. However, during the healing phase the patient may find it hard to get an erection and even if they get it they will find it very uncomfortable. During the healing phase it is recommended to avoid any kind of sexual activity or masturbation as continuing it may delay the healing process and cause further trauma[1, 2].
In majority of the cases, no specific medications are necessary but NSAIDs are at times given for symptom control by some physicians. For people with sexually transmitted infection as a cause of Sclerosing Lymphangitis, additional treatment for the infection will also be rendered in the form of a course of antibiotics[1, 2].
Since Sclerosing Lymphangitis is a rare condition, there is not much data with regard to any complications that may arise from it. This is also in part due to the lack of research on this condition. However, in short term as of now there have not been any major complications identified aside from having problems with sexual activity and that too till the swelling subsides[2].
