title: The hard penile circumferential fold as the presenting finding in primary syphilis: report of six cases.
abstract: BACKGROUND
  Six patients with firm circumferential folds located in the balanic sulcus of the penis were studied.
  
  
  OBJECTIVE
  The purpose of the study was to determine the origin of the lesions.
  
  
  METHODS
  These patients were examined clinically, with dark-field examination when possible and with a serologic test for syphilis.
  
  
  RESULTS
  All patients had reactive serologic tests for syphilis and had enlarged, firm, nontender, inguinal lymph nodes.
  
  
  CONCLUSIONS
  Although we were unable to prove with certainty that the origin of these folds was syphilitic, all patients had clinical and serologic findings that supported the diagnosis of primary syphilis.
authors.affiliation: Department of Urology, University of Southern California, Los Angeles.
authors.forename: A M
authors.initials: AM
authors.lastname: Goldstein
authors.forename: J N
authors.initials: JN
authors.lastname: Fox
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000175:diagnosis* / Q000473:pathology; D010413:Penis / Q000382:microbiology / Q000473:pathology; D013587:Syphilis / Q000175:diagnosis* / Q000473:pathology; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum / Q000302:isolation & purification