[Question #10243] White patches on penis shaft
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24 months ago
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A couple weeks ago, I noticed two light white patches on the shaft of my penis. I would describe them as more loss of pigmentation. I would say the size is an eraser head of a pencil. Not raised, bumpy, itchy or painful. I had sex twice during a split up. Both intercourse protected with condom (no breakage) and on one occasion brief oral sex (receiving) unprotected with an escort. The last occasion was 6-8 weeks ago. I know have another very mild spot same size starting on the base of my penis. I've had no symptoms except for darker than normal urine, but still yellow. From what I have read it doesn't meet the profile of any STI but maybe I'm missing something. Some have suggested vitiligo? I have an appt to see my GP next week, just looking for some reassurance as I am back in a relationship.
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H. Hunter Handsfield, MD
24 months ago
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Welcome to the forum. Thanks for your confidence in our services.
I agree this doesn't sound like any STI. (While it is certainly understandable why sexually active persons with genital skin problems often think first of STI, mostly they are not. I have a book titled Genital Dermatology Atlas. As the name implies, it's full of color photos. All STIs are covered in only 15 of its 300 pages.)
While we don't go into detail on non STD issues, I agree with the "some" you found who suggested vitiligo; your description is very typical. You can google it for much information including photos. It's basically loss of skin melanocytes, the cells that produce melanin pigment. The cause is unknown; the most common belief is that's it's due to autoimmunity, i.e. the immune system destroying or damaging the melanocytes. It's actually quite common, occurring in up to 1% or even 2% of some populations. The penis is a common site in men, but it can occur anywhere on the body. Vitiligo can be very disturbing when it occurs in cosmetically important areas, especially the face, and (no surprise) can be especially upsetting in dark skinned persons.
The main thing that might change this judgment is if the involved patches have any visible inflammation -- a pink tone, skin flaking, or slightly raised. Such appearances could go along with the rash of secondary syphilis. However, I doubt it based both on the description and your sexual history. See your GP as planned. If there is any doubt about the syphilis business, a syphilis blood test would settle it; these tests always are strongly positive in secondary syphilis. I'm still betting on vitiligo.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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24 months ago
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Thank you. I'm appreciate the prompt reply. They patches have no inflammation and or colour. They appear under the skin layer. Just that you did mention syphilis, I have had no additional rash or other symptoms. Would that even be a possibility based on having 2x protected sex and brief oral. I think that it something I would consider moving forward prior to having even protected sex. The two white patches are located just beneath the penis head which was most definitely covered by a condom. I was under the impression syphilis would start with a single chancre that is quite pronounced.
Is it possible they start as white patches similar to what I describe?
Wouldnt I have noticed a first stage of syphilis?
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24 months ago
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Just to add to that my last "encounter" was 70 days ago. For a timeline when does syphilis begin to show any symptoms? Just wanted to add that to my questions and I will conclude with your response.
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24 months ago
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No change in the size or development of the original two small patches in two weeks, just not going away.
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H. Hunter Handsfield, MD
24 months ago
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Don't over-interpret my comments about syphilis. It is exceedingly unlikely that it explains any of these problems. If you remain concerned about it, have a blood test; the expected negative result will be conclusive. I suggest waiting until you see your GP and let her or him know your concerns.---