Confused

[metalmadness]

In January, i received oral sex from a stranger i met at a bar. I had stinging around the tip of my penis for weeks, but the tests for gonorrea/chlymdia were negative. 6 weeks after receiving oral sex, I developed a small white scab/patch of dry skin near the head of my penis on the shaft. I was puzzled how this scab/dry patch could form without a blister which never developed(It seemed to appear overnight as I was very observant in looking for bumps or blisters and never found any)It was about half the size of an eraser(on a pencil)with no redness around it, and if you wet it, it would disappear for awhile (hour or two). It appeared to be a little scaly. The scab took about 4 weeks to heal and towards the end it appeared a little pink. You could still see remants of it...by that I mean the skin in that area is a little lighter than the surrounding area. I must also mention that the scab was never painful, although it did get a little itchy as it started to disappear. My doctor said that it didn't look like herpes but could not diagnose what exactly it was.

The response from the STD expert on this site(M.D.-HHH)is as follows:

"Herpes is the most common cause of genital sores. However, it started too late to be something you caught during the oral sex episode you describe; and herpes usually is painful, although not always. Syphilis is possible and the timing is right, but a "white scab" (by which I assume you mean a dry lesion) is atypical.

Most likely, it is entirely unrelated to the oral sex exposure and not an STD. From your description, psoriasis comes to mind. It often affects the penis, and a white, scaly, scab-like lesion is typical. Psoriasis would be especially likely if you have similar spots elsewhere on your body; or if you have dandruff. (Many cases of apparent dandruff actually are due to psoriasis of the scalp.) But many other kinds of dermatitis also are possible...You cannot and should not assume you have herpes "

I do have mild dandruff (I can generate flakes by rubbing my head) but no real major dry spots elsewhere except for a little dryness on the skin just outside of my fingernails.

I'm very interested in your thoughts about this dry scab or patch.

[Alan Rockoff, MD]

I agree with Dr. Handsfield.  The rash your describe could be nothing more than mild irritation, perhaps aggravated by your closely examining it.  An STD seems remote, to say the least.  My advice is to forget about it, leave the spot alone, and show it to a skin doctor in the unlikely event that it persists more than a month.

If oral sex with a stranger causes you so much anxiety, you should avoid it.

Best.

Dr. Rockoff