History

Usually in Peyronie disease, the penis hurts only during an erection. This pain occurs in one third of patients. Penile curvature of varying degrees may be observed, only during an erection. No history of a congenital malformation of the penis (eg, chordee) or a metastatic cancer is present. Risk factors for Peyronie disease include history of erectile dysfunction and history of coital trauma to the penis.^[7]

Physical Examination

On palpation, a fibrotic plaque, usually greater than 1.5 cm in diameter, is felt over the penile shaft, usually either ventrally or dorsally.

The erect penis may be curved, or it may have an hourglass deformity with flaccidity of the distal penis. The patient can obtain photographs of the erect penis in private to demonstrate the increased curvature. Self-taken photographs can be used to establish a reference point for subsequent observation or treatment.

Evidence suggests that pain tends to lessen with time, but fibrosis and/or deformity tend to increase or persist. Waiting 12-24 months for the plaque to stabilize before surgical intervention is typical.

Complications

Complications of Peyronie disease include the complete inability to maintain sexual performance.

Differential Diagnoses

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Media Gallery

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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Author

Anne Elizabeth Laumann, MBChB, MRCP(UK), FAAD Professor Emerita 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, American Academy of Dermatology Association, American College of Wound Healing and Tissue Repair, American Dermato-Epidemiology Network, Association for Psychoneurocutaneous Medicine of North America, Association of Professors of Dermatology, British Association of Dermatologists, Chicago Dermatological Society, Chicago Medical Society, Dermatology Foundation, European Society of Tattoo and Pigment Research, Illinois Dermatological Society, Illinois State Medical Society, Institute of Medicine of Chicago, Lupus Foundation of America, Illinois Chapter, Medical Dermatology Society, National Psoriasis Foundation, National Vitiligo Foundation, North American Rheumatologic Dermatology Society, Rheumatologic Dermatology Society, Scleroderma Foundation, Society for Investigative Dermatology, The Global Fibrosis Foundation, Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Joseph J Pariser, MD Assistant Professor of Urology, Department of Urology, University of Minnesota Medical School

Disclosure: Nothing to disclose.

Victoria Godinez-Puig, MD Resident Physician, Department of Dermatology, Northwestern University, The Feinberg School of Medicine

Victoria Godinez-Puig, MD is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: Nothing to disclose.

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

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

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, American College of Rheumatology

Disclosure: Received income in an amount equal to or greater than $250 from: Biogen US (Adjudicator for study entry cutaneous lupus erythematosus); Priovant (Adjudicator for entry into a dermatomyositis study); IQVIA (Serono - adjudicator for a study of cutaneous LE) <br/>Received honoraria from UpToDate for author/editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for these trust accounts for: Stocks held in various trust accounts: Allergen; Amgen; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble;; Celgene; Gilead; CVS; Walgreens; Bristol-Myers Squibb.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

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, California Medical Association

Disclosure: Received consulting fee from Allergan for consulting; Received consulting fee from Centocor for consulting; Received consulting fee from Galderma for consulting; Received consulting fee from Coria Labs for consulting.