Genital Lentiginosis/Lentiginous Melanosis

Hello Dr. Rockoff,
I am a 27 year old white male with no family history (atlest to my knowledge) of skin cancer.  I have genital lentiginosis(it seems each derm. has a slightly different name for it) diagnosed by multiple dermatologist.  I have had this for approximately 10 years, and slowly but surely it has spread.  The best description I can give is that they are dark spots(all confined to the head of my penis)  that are not raised but are multiple and have irregular borders.  These dark spots also skip areas but the main "area" is somewhat confined and that is where the spots are the most prevalent.  I don't have any pictures, just please believe me when I say that the lesions are now pretty darn extensive.  The lesions range in colors and some areas are darker than others, none however are black or a dark blue.  The dermatologist that I am sticking with for the rest of this due to my personal liking of him and his attitude toward the situation currently has me putting retin a micro on them for the next 4 to six months to see if that helps fade them before anything surgical.  Because of my obvious concerns I have asked the dermatologist if he thinks this could be cancerous, and he replied politely but extremely firm "No way, no how"  He said if the retin a did not help he would freeze them off.  I have read online about genital lentiginosis and some medical reviews say that cryosurgery is the best way and some say laser surgery.  What do you think?  I also am curious if he is going to do a biopsy before hand because I read that this is common practice?  If he does, will a biopsy in this sensitive are do some major damage( what kind of biopsy?)  And also, if I go through with the cryosurgery, will it most likely keep this from coming back, or is that not known?  Do you even think cryosurgery will take this away?  Will I properly heal from cryosurgery?  And finally, what the hell causes this?
Thanks in advance Doc.  

[Alan Rockoff, MD]

You may call yourself "scaredsick,"  but I see no reason for you to be that way.  These are spots, not cancers.  Maybe the doctor will want to biopsy one, just to establish the diagnosis, but that's a superficial, trivial procedure that causes no damage.  I don't know whether either cryosurgery or laser would work, but either one might do so safely, so test areas would be a good idea.  If the treatments don;t work, you might just have to live with the spots, which shouldn't be the end of the world.

I advise you to listen to your doctor and take things slow and steady.  No need for such anxiety.

Best.

Dr. Rockoff