heroin and Penile-Diseases

Long-term intravenous heroin abusers have problems of vascular access. After the accessible sites are sclerosed, the neck, axillae and groins are then used frequently. We report on 3 heroin abusers who presented with localized gangrene of the genitalia after injection into the femoral vessels. We postulate that the pathophysiology of this entity is related to arterial embolization of particulate matter into the microcirculation of the genitalia, which causes arterial thrombosis leading to localized gangrene. Of the 3 patients 2 were treated with local excision, débridement and primary closure. A fourth addict who injected heroin directly into the scrotum and perineum, presented with Fournier's gangrene, a completely different, more lethal entity.

Topics: Adult; Femoral Artery; Femoral Vein; Gangrene; Genital Diseases, Male; Heroin; Humans; Injections, Intra-Arterial; Injections, Intravenous; Male; Middle Aged; Penile Diseases; Scrotum; Substance-Related Disorders

The rarity of reported cases of cutaneous ulcerations in heroin abusers prompts this report of a 25-year-old man with a painless, slightly necrotic and purulent ulcer of the dorsal shaft of the penis. The differential diagnosis of the lesion and cutaneous manifestations of heroin abuse are reviewed. To our knowledge, this is only the second reported case of penile ulcer from heroin injection.

Topics: Adult; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Male; Penile Diseases; Skin Ulcer

Topics: Adult; Ampicillin; Diagnosis, Differential; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Male; Penile Diseases; Skin Ulcer; Staphylococcal Infections; Substance-Related Disorders