Unusual presentation of sclerosing lymphangitis of the penis with large ulcerations

Sclerosing lymphangitis of the penis (SLP) is a rare, benign condition typically presenting as a cord-like swelling. We report an unusual case of SLP in a 75-year-old circumcised man with marked penile edema and deep ulcerations. STI screening was negative. After 2 weeks of sexual abstinence and local care, the ulcerations healed, revealing the characteristic SLP cord. The penile swelling resolved completely after 2 months. This presentation is unique due to the patient’s age and the prominent edema and ulcerations, suggesting these features may indicate a severe clinical form of SLP that only manifests its typical appearance after the initial acute phase resolves.