[Question #8113] Chancre or hpv

48 months ago

I had a whitish almost shiny bump show up on my glans months ago. It didn’t itch or cause pain it was just noticeable. Had unprotected sex over a month prior. The bump was a few cm and it was raised. It lasted for at least a month. Didn’t leak or anything I finally took a sterile needle and poked it several times( which I know was dumb) but it bled and ended up disappearing shortly after that. I can feel lymph nodes in my groin as well. They feel to be maybe 1 cm maybe a tad bigger but don’t hurt and they’ve been that way since. Maybe before I’m not sure but I didn’t start checking them until the bump happened. Had a rash on my left inner elbow that itched and went away after 2 weeks but haven’t had one elsewhere. Also night sweats but these haven’t occurred together. Also had regular bloodwork done CBC differential and my results were all within normal range. Scared to death it could have been syphillis and online I read so many contradictions on primary syphillis sores. Please help.

H. Hunter Handsfield, MD

48 months ago

Welcome to the forum. Thanks for your confidence in our services.

From your description, it is very unlikely the penile lesion was syphilis. HPV can cause such variable skin lesions that it might be a possibility, but even HPV would be unlikely based on your description. The large majority of genital skin problems (probably well over 90%) are caused by various non-STI problems. Some are specific to the genitals (i.e. occur mostly in the genital area), whereas others are random occurrence of skin issues that can appear anywhere but happen to involve the penis, scrotum, labia, etc. My professional library includes a book titled "Genital Dermatology Atlas". As the name implies, it is filled with photos and brief descriptions of genital rashes and other skin problems. Of its 300 pages, all STIs are covered in 15 pages.

What might it have been? Very hard to say, but among the most common non-STI problems that might be responsible for a "whitish" and "shiny" bump is called lichen planus; you might google it for photos to see how it compares with what you observed. LP is a trivial condition except in rare cases that it becomes extensive and a potential cosmetic problem. If it should recur or similar lesions appear, I would suggest you see a physician, ideally a dermatologist.

Other than one episode of "unprotected sex", you say nothing about your STI risks. But if single and dating, or otherwise having occasional (or frequent) sex with non-monogamous partners, it would make sense to have periodic STI testing, which would include a syphilis blood test. I would give the same advice whether or not you had had the penile bump a few months ago.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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48 months ago

The shininess may be because of lighting when I first saw it. More of a pale white color in normal lighting. I was monogamous other than the occurrence that happened A few months before that bump appeared. I’ve googled hpv and Lp and it’s somewhat similar to them. I was also on ibuprofen 800 mg for a an abcess a few weeks before it came up. Will get sti testing soon, googling gave me contradicting details about a syphillis chancre which is what I was most worried about but for the most part I read that in primary they are ulcers and this wasn’t ulcerated or open and wet at all.

H. Hunter Handsfield, MD

48 months ago

Thanks for the follow-up. I agree this was not at all suggestive of primary syphilis, which indeed would have been an ulcerated lesion (chancre). Lichen planus still seems a good bet, but conceivably it was a manifestation of secondary syphilis called mucous patch -- but in that case you would have had to be infected 3-12 months earlier. Play it safe and have a syphilis blood test. It's unlikely I would have anything helpful to say until then, so let's hold off on further discussion until that has been done.---