[Question #2317] Spot on Penis

45 months ago
Hello- I've wrote you you before and needed some help. 6 weeks ago had protected oral and vaginal with a woman. Used condom for both. Condom was intact the whole time. I was on doxy for acne and you told me not to worry about syphilis but to make me feel better, I took RPR test at four weeks and it was negative. Went to dermatologist to have him look razor burn on pubic area and he said it was just that and not herpes. He also biopsied a small wart on shaft for HPV and it was negative. Fast forward to about two weeks ago. I had protected sex with regular partner and unprotected oral. I have a small pink circle on the upper shaft of penis. Right below the head. It doesn't hurt nor itch. It's just a pink/reddish circle. Little bit of dry skin came off top but it doesn't hurt at all. Any advice on what this might be would be appreciated. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
I'm sorry to see you remain so concerned about all this despite the reasoned, science-based reassurance you had from Dr. Hook.

Your description suggests this is the same spot on your penis you described in your previous thread a month ago. It doesn't sound at all like herpes or any other STD. The large majority of genital skin problems are not STDs. In fact, I have a book title Genital Dermatology Atlas, filled with photos and descriptions of rashes, sores, spots, etc. Of its 300 pages, only 15 are about STDs. The rest are various conditions that usually affect the genitals, as well as many general skin problems that just happen to be on the penis, scrotum, labia, etc. 

As I recall, your previous description to Dr. Hook described it as shiny. On that account, google a condition called lichen planus, one of the most common genital rashes, and see if the photos are similar to your problem. However, the appearance of a bit of flaking skin is atypical for LP. This could be any of several things and I cannot guess further. Whatever it is, it doesn't sound serious; most problems like this are minor and easily treated. This forum is strictly for STD problems; we do not attempt to diagnose non-STD genital problems and no STD behaves this way. It has nothing to do witih your sexual exposure a few weeks ago. You'll need to see a doctor (ideally a dermatologist) for accurate diagnosis.

Good luck --  HHH, MD
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45 months ago
Thank you Doctor. Sorry for bothering you. I do need to speak to someone about my anxiety. To be clear, herpes wouldn't show up where the condom was fully covering my penis, correct?  This small bump is towards the top. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
Herpes usually doesn't appear on condom-covered skin, but it can happen when fluids slosh inside the condom; or if the penis slides within the condom. But that has nothing to do with my judgment that this isn't herpes, which simply does not look or behave as you have described. Ever, period, no exceptions.

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45 months ago
Ok thank you. My last and final follow up question is in regards to LP then. What would cause it? I don't use condoms with my normal partner. Could this cause irritation that causes this flat, pink, shiny circle on my shaft? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
45 months ago
I don't know that lichen planus is what you have, but "flat" and "shiny" would fit. The cause is unknown. It is unrelated to sex and is not contagious. Here's a website with more information:  https://www.aad.org/public/diseases/rashes/lichen-planus.

That completes the two follow-up comments and replies included with each question and so concludes this thread. Please note the forum does not permit repeated questions on the same topic or exposure. This being your fourth question overall and your second on this particular topic, it will have to be your last; future new questions about this exposure and your concerns about herpes, other STDs, or the cause of the spot on your penis will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, continued answers tend to prolong users' anxieties. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.

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