Melanotan Tanning Injection: A Rare Cause of Priapism.

This case report by Mallory, Lopategui, and Cordon (Sexual Medicine, 2021) describes a single patient who developed acute ischemic priapism following subcutaneous self-administration of Melanotan II, a synthetic melanocortin analog that is illicitly sold online and used in unlicensed clinics as a sunless tanning agent and sexual stimulant. The authors note that Melanotan II has also been investigated as a potential treatment for erectile dysfunction. In this case, standard first-line management — including cavernosal aspiration, irrigation, and intracavernous phenylephrine injection — failed to achieve detumescence. The patient ultimately required surgical intervention via penoscrotal decompression, which the authors describe as a promising technique for refractory ischemic priapism. The report notes that priapism associated with Melanotan II had only been documented twice previously in the literature. The authors conclude that priapism should be recognized as a possible adverse effect of Melanotan II and that future therapeutic investigations and clinical guidelines should account for this risk. Key limitations include the inherent constraints of a single case report: findings cannot be generalized, causality cannot be definitively established, and no controlled comparison is possible.

Why this grade: A single case report in one human patient provides only anecdotal, non-controlled human evidence; it cannot establish causality or generalizability.