Nicorandil is a drug used to treat angina pectoris. It can cause ulceration at a variety of sites including the penis.
Patient selection: penile ulcer
Clinical features:
(1) The patient is taking nicorandil.
(2) Other causes of penile ulceration are excluded, with careful exclusion of malignancy.
Differential diagnosis:
(1) squamous cell carcinoma
(2) syphilis or other sexually-transmitted disease
(3) Crohn's disease
(4) trauma
(5) dermatitis herpetiformis
(6) Behecet's disease
Nicorandil needs to be discontinued and alternative therapy initiated.
Circumcision may be necessary but should be deferred until there is clear evidence of re-epithelialization (O'Neill et al).
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Specialty: Urology, Pharmacology, clinical