Asymptomatic, shiny, red, and flaky recurrent penile spots on head and shaft - please help!

Hello, for the past two years or so I have had spots on the shaft of my penis. Recently they have begun to appear on the glans (glands) as well. They are fairly small, not raised, dry, red, somewhat shiny, and flaking (at least on the shaft). They do not itch or hurt in any way. I have had an STD and HIV test, which was negative for everything tested, and had not had a sexual partner for 2 years prior to the appearance of the problem. I am now 24 years old.

I have been to several doctors and have therefore tried the following things: ketoconazole and other anti-fungals, a one-time cream to kill mites on the off-chance that it was crabs, and keeping the affected area dry for a month or so (using baby powder) as well as moist for a month or so (using neosporin or lotion). None of these things have had any effect whatsoever, and the most recent doctor thinks that they are simply a dermatitis of sorts.

The only thing that does work are topical steroids, triamcinolone, which completely "heal" the patches within a few days, when applied once or twice per day, only to have them reappear again within a week. What's more, they come back in a slightly larger area each time, now affecting the glans (glands) penis.

What would you recommend doing next? Any idea what this is? Is it contagious, since I now have a girlfriend and we are sexually active?

[Bhupinder Kaur, MD]

Hello,

For such spots, eczema skin and psoriasis patches should be evaluated. Psoriasis is a non-contagious disorder which affects the skin and joints. It commonly causes red scaly patches to appear on the skin. It can be treated but it commonly has recurrences also. So a regular treatment is required for this.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.