[Question #4353] Secretion at base of glans

31 months ago
Hello Drs, thank you very much for your services.

I have developed at the base of the glans of my penis (actually at shaft, exaclty at the region that glans begins) a transparent secretion. Ive note that 2 days ago, it is very near the frenulum.
Bellow this secretion, it is possible to observe, with direct light on it, a reddish region/patch.
It does not itch, nor any pain.

I will schedule a meetinng with a urologist, but in the meantime I decided to apply isoconazol on it. The result is that afther some time the secretion now is white.

I know it is very hard to diagnose from here, but I hope to get some guidance from you.

Ive been having sex relations unprotected only with my wife. 

As you know due our previous interactions, I had a sex encounter with GSW one year ago, that was traumatic for me.  My last tests were 5 months later this GSW encounter (march this year), all negative including hiv, hep B ans C, gono, chlamydia and sypphilis.

I also had a mouth ulcer in the last week, appeared before the penis lesion.

1) do you know what this lesion could be?
2) any possible relation with the gsw encounter?

Thank you very much.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
This is your fifth or sixth question about various minor symptoms ever since a sexual exposure that you obviously are still obsessed by. As you know, we cannot diagnose anything and don't try.

1) I doubt anything serious is wrong. I'll comment only on the one STD issue that could cause a faint red patch of skin with some secretion:  syphilis. If you had syphilis in the secondary stage, this description suggests the possibility of a skin condition called condyloma lata. Your negative blood test showed for sure you cannot have syphilis from the extramarital exposure a year ago. Of course, whenever one member of a relationship has extramarital sex, often the other partner has done so as well. If that applies to your wife and she has syphilis, perhaps you have caught it from her. Of course you're in a much better position than I am to judge if this is likely.

2) For the reasons above, this cannot have anything to do with that sexual encounter.

You're doing the right thing by seeking medical care. Depending on where you are, a urologist may or may not be the best choice. In some countries (e.g. Japan, Korea), most STD experts are urologists. In North America and Europe, many urologist have little STD expertise and are not necessarily expert at diagnosing genital skin problems. OTOH, the main STD need is for a syphilis blood test, and any doctor or clinic can do that. If negative, it will prove (once again) that you don't have syphilis.

It was not smart to start to treat the skin problem with isoconoazole, or with anything else. That's a good way to make it harder for any doctor to diagnose. Stop treating yourself entirely until you have seen your doctor.

30 months ago
Hello Dr HHH, thank you for your reply. 
Im at South America, so it may be different also. I went then to and urologist and a infectologist.
The secretion was gone by the that time, and the urologist thought it would be candida infection.  He prescribed me Itraconazol. I also asked for the blood tests.
The infectologist was more intrigued, because at the specific location it would be very hard to have a secretion. He also asked to do the sypphilis test (I guess he was suspecious as well).  Additonaly to the blood tests, he asked me to do a culture analysis of the secretation (that I dont have anymore).
I did the blood tests, all negative for hiv, sypphilis, hepb and hepc. So I assume that those can now be ruled out for sure, correct?
Ive noted that this was the firts time I did this sypphilis test method (CMiA). All the other tests I did was called RPR floculation, and this is CMIA ANTIBODY test. Does this change anything, or make the test less reliable at this stage?

Thank you very much.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
These syphilis blood tests all are valid (each is conclusive all by itself). They prove for that syphilis is not the cause of this problem. It is not possible that viral hepatitis or HIV could cause something like this, but those blood tests also are valid.

I have no other advice about this. I'm sure it has nothing to do with any STD or any condition you caught from any sex partner. Continue to work with the infectious diseases specialist. Good luck.