title: Nicorandil-induced penile ulceration: a case report.
abstract: BACKGROUND
  Penile ulceration in older patients is commonly neoplastic or infective. However, there are rarer causes of these ulcerations that we have to exclude. We present a rare complication of penile ulceration secondary to nicorandil, a nicotinamide ester.
  
  
  METHODS
  An 86-year-old white British man was referred with a bloody discharge from under his phimotic foreskin and a lump on the shaft of his penis for the past year. He had angina which has been controlled with nicorandil for the past 5 years. A surgical biopsy of the ulcer showed inflammation with no evidence of malignancy. His penile ulceration spontaneously resolved when he stopped his nicorandil treatment.
  
  
  CONCLUSIONS
  Nicorandil-induced ulceration is a rare complication; however, it should not be missed in a clinical setting. If there is any doubt about the cause of penile ulceration, then referral to dermatology or urology for consideration of biopsy is essential.
authors.affiliation: Department of Urology, Royal Gwent Hospital, Cardiff Road, Newport, NP20 2UB, UK. darrenyap.jx@gmail.com.
authors.forename: Darren
authors.identifier: http://orcid.org/0000-0003-4671-2110
authors.initials: D
authors.lastname: Yap
authors.affiliation: Department of Urology, Royal Gwent Hospital, Cardiff Road, Newport, NP20 2UB, UK.
authors.forename: Omar
authors.initials: O
authors.lastname: Aboumarzouk
authors.affiliation: Department of Urology, Royal Gwent Hospital, Cardiff Road, Newport, NP20 2UB, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bates
mesh_terms: D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D020108:Nicorandil / Q000009:adverse effects*; D010409:Penile Diseases / Q000139:chemically induced*; D010413:Penis / Q000187:drug effects; D014456:Ulcer / Q000139:chemically induced*; D014665:Vasodilator Agents / Q000009:adverse effects*
chemical_list: D014665:Vasodilator Agents; D020108:Nicorandil
keywords: Anti-anginal; Nicorandil; Nicotinamide; Penile; Ulceration