Bump on pubic area, near penis

[Accadana]

Hello Doctor:   For the last 3 months or so, I´ve had this small, "dome" like bump, in my pubic area, just where the penis begins.  It looks like a pimple.  Its "skin" colored and its only one.  When I first noticed it, three months ago, I went to the doctor and he said it was foliculitis, and he gave me salicilic acid.  To be honest, I didn´t use it every day, in fact when I noticed that the bump reduced it self, I stopped using it.  I was not consistent with its aplication, and the bump is still there.  I squeezed it last night, and just a little bit of blood came out, no pus.  It does not hurt, nor does it itch.   I am heterosexual, and sexually active, and have had sex with  many different women over the course of the years.  I have always used a condom, with the exception of my ex ex girlfriend, with whom I broke up about 2 years ago.  My last sexual encounter was 15 days ago, always with a condom.  Yesterday I was getting a little freaked out, because since yesterday I have been experiencing a tingling sensation on the top of my penis, but it could be nothing, and just me, being paranoid.  I have taken a picture of the bump, and would like to submit it to you.  Can you advise me please?

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I can understand your concern for the bump given your history of recent sexual exposure and probable tingling in the penis.

But from your history that similar bumps are present on other areas of the body it looks like a sebaceous cyst. It is less likely to be due to irritated hair follicle or folliculitis because it has been present for three months and folliculitis does not persist for so long. Moreover since your last sexual exposure was 15 days back and the lump has been present for three months, it is less likely to be due to STD’s like herpes. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. When signs do occur, they typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal the first time they occur.

The other possibilities apart from sebaceous cyst which I can think of are swollen lymph node and a HPV wart. A sebaceous cyst is a closed sac occurring just under the skin which contains a "pasty" or "cheesy" looking substance called keratin. They may occur anywhere on body but scalp, ears, back, face, and upper arm, are common sites for sebaceous cysts. They can also be found on the hair rich pubic area. Blocked sebaceous glands, swollen hair follicles and excessive testosterone production will cause such cysts and excessive sweating can be one of the reasons for such a cyst.

Generally no treatment is required but they become painful then it means they are infected, then surgical excision by traditional wide excision, minimal excision, and punch biopsy excision may be required.

However it is important to rule out the other mentioned possibilities as well for which I suggest you to get a physical examination done from a urologist. There is currently no FDA-approved test to detect HPV in men. Genital warts can be diagnosed through visual examination of the penis and surrounding areas.

If needed, a FNAB can be done. FNAB is fine needle aspiration biopsy which is aspiration of the material of the lump which is done by a fine gauge needle (22 or 25 gauge) and a syringe. This will confirm the diagnosis as most likely this lump is due to an infection causing an abscess, swollen lymph node or a benign growth.

Hope that this information helps and hope that you get better soon.

Wishing you good health.

[Accadana]

I also forgot to mention, that I do a lot of exercise per week, and sweat a lot.  Thank you.

[Accadana]

I would like to add, that I have  similar bumps on other parts of my body, like the side of my nose, and parts of my leg.  They are skin colored.  The fact that I have one on my pubic area, has raised my concern though.  Thank you.