A 34-Year-Old Man Comes to the Office Due to Erectile

A 34-year-old man comes to the office due to erectile dysfunction.  For the past 2 months, he has had pain and penile curvature during erections, which has made vaginal penetration difficult and has started to adversely affect his self-esteem.  The patient has had no urethral discharge or other symptoms.  He smokes a pack of cigarettes daily and does not use alcohol or illicit drugs.  The patient has had a total of 5 female sexual partners.  Vital signs are within normal limits.  Cardiopulmonary examination shows no abnormalities.  The abdomen is soft and nontender with no masses.  There is no inguinal lymphadenopathy.  A palpable plaque is present on the dorsal side of the penis approximately half way between the glans and the pubis.  The testes are normal with no scrotal erythema or skin ulceration.  Which of the following is the most likely diagnosis?

A) Genital warts
B) Penile cancer
C) Peyronie disease
D) Systemic sclerosis
E) Tertiary syphilis

Correct Answer:

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