Dermatologic Manifestations of Peyronie Disease Medication

  • Author: Jay W Zimmerman, MD, FAAD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 22, 2012
 

Medication Summary

The following treatments for Peyronie disease are only temporizing.

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Vitamins

Class Summary

The antioxidant properties of vitamin E may limit the extent of inflammation. Vitamin E is inexpensive, has few adverse effects, and has anecdotal usefulness.

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Vitamin E (Amino-Opti-E, Aquasol, E-Vitamin)

 

Protects polyunsaturated fatty acids in membranes from attack by free radicals and protects red blood cells against hemolysis.

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Nutrients and nutritional agents

Class Summary

These agents may improve pain and lessening of penile curvature. Their efficacy is not clearly established.[35]

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Potassium p-aminobenzoate (Potaba)

 

Potassium p-aminobenzoate may enhance monoamine oxidase activity and thereby lower the local level of serotonin that is thought to be a stimulant for fibrosis.

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Antihistamines

Class Summary

The initial stage of a Peyronie disease plaque involves histamine-mediated inflammation. Anecdotal evidence suggests that an antihistamine may limit this inflammation.

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Fexofenadine (Allegra)

 

Competes with histamine for H1 receptors in GI tract, blood vessels, and respiratory tract, reducing hypersensitivity reactions. Does not cause sedation.

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Anti-inflammatory agents

Class Summary

These agents may help patients with Peyronie disease by reducing inflammation.[36]

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Colchicine

 

Decreases leukocyte motility and phagocytosis in inflammatory responses.

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Estrogen receptor antagonists

Class Summary

These agents inhibit TGF-beta actions and inflammatory reactions. TGF-beta and inflammatory mediators are involved in the production of Peyronie disease plaques in animal studies. Only anecdotal evidence for use of these agents exists.[13, 37]

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Tamoxifen (Nolvadex)

 

Competitively binds to estrogen receptor, producing a nuclear complex that decreases DNA synthesis and inhibits estrogen effects.

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Calcium channel blockers

Class Summary

Anecdotal evidence shows some lessening of the scarring process after intralesional injections. The theory is based on the known action of verapamil in decreasing the production and secretion of extracellular matrix macromolecules by fibroblasts while increasing collagenase production in the same area.

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Verapamil (Calan, Covera-HS, Verelan)

 

Relaxes smooth muscles and increases oxygen delivery during vasospasms.

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Nonsteroidal anti-inflammatory agents (NSAIDs)

Class Summary

These agents have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclo-oxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well; these include the inhibition of the following: leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

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Aspirin (Anacin, Ascriptin, Bayer Aspirin, Bayer Buffered Aspirin)

 

Used to treat mild to moderate pain. Inhibits prostaglandin synthesis, which prevents formation of platelet-aggregating thromboxane A2.

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Acetaminophen (Tylenol, Feverall, Tempra, Aspirin Free Anacin)

 

DOC for treatment of pain in patients with documented hypersensitivity to aspirin or NSAIDs or upper GI disease and who are taking oral anticoagulants.

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Ibuprofen (Motrin, Ibuprin)

 

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Naproxen (Aleve, Naprelan, Naprosyn, Anaprox)

 

For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing activity of cyclo-oxygenase, which decreases prostaglandin synthesis.

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Etodolac (Lodine)

 

Inhibits prostaglandin synthesis by decreasing activity of the enzyme, cyclo-oxygenase, which results in decreased formation of prostaglandin precursors, which in turn results in reduced inflammation.

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Flurbiprofen (Ansaid)

 

May inhibit cyclo-oxygenase enzyme, which, in turn, inhibits prostaglandin biosynthesis. These activities may result in analgesic, antipyretic, and anti-inflammatory effects.

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Ketoprofen (Actron, Orudis, Oruvail)

 

For relief of mild to moderate pain and inflammation. Small doses initially indicated in small or elderly patients or those with renal or liver disease. Doses >75 mg do not increase therapeutic effects. Administer high doses with caution, and closely observe patient for response.

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Piroxicam (Feldene)

 

Decreases activity of cyclo-oxygenase, which, in turn, inhibits prostaglandin synthesis. These effects decrease formation of inflammatory mediators.

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Interferon intralesional injections

Class Summary

Interferon slows fibrogenesis, inhibits RNA synthesis, and inhibits oxidative stress

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Interferon alfa-2b (Intron A)

 

Intralesional injections of interferon alfa-2a may be effective in decreasing plaques and scarring.

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Nonselective phosphodiesterase inhibitors

Class Summary

These agents may reduce plaque size and penile curvature.

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Pentoxifylline (Trental, Pentoxil)

 

Off-label use. May alter rheology of red blood cells, which, in turn, reduces blood viscosity. May be used, but with extreme caution of hemorrhage.

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Contributor Information and Disclosures
Author

Jay W Zimmerman, MD, FAAD  Consulting Physician, Berman Skin Institute, Palo Alto

Jay W Zimmerman, MD, FAAD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, and California Medical Association

Disclosure: Allergan Consulting fee Consulting; Centocor Consulting fee Consulting; Galderma Consulting fee Consulting; Coria Labs Consulting fee Consulting

Coauthor(s)

Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD  Professor, Department of Dermatology, Northwestern University, The Feinberg School of Medicine

Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD is a member of the following medical societies: American Academy of Dermatology, Association of Professors of Dermatology, British Association of Dermatologists, Chicago Dermatological Society, Chicago Medical Society, Illinois Dermatological Society, Illinois State Medical Society, Illinois State Medical Society, Medical Dermatology Society, and Society for Investigative Dermatology

Disclosure: Abbott Grant/research funds Other; Regeneron Grant/research funds Other; Centocor Grant/research funds Other; Celgene Grant/research funds Other

Gregory Bales, MD  Associate Professor, Department of Surgery, Section of Urology, University of Chicago

Gregory Bales, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Terry L Barrett, MD  Clinical Professor of Dermatology and Pathology, University of Texas Southwestern School of Medicine; Director, ProPath Dermatopathology, Dallas, Texas

Terry L Barrett, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Medical Association, American Society of Dermatopathology, College of American Pathologists, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD  Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and American College of Rheumatology

Disclosure: Amgen Honoraria Consulting; Celgene Honoraria Safety Monitoring Committee

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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Lateral view demonstrates vertical curvature.
Superior view shows a full erection.
Postoperative picture after surgical repair demonstrates a straight erection.
Intraoperative picture of an artificial erection demonstrating lateral curvature.
Intraoperative picture after penile plication demonstrating a straight erection.
 
 
 
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