Hypopigmentation spot on my penis shaft

I am a 30 year old olive-complexion italian male.  A few weeks ago I noticed a 5mm discolored spot on the shaft of my penis.  The spot is smooth, not raised, not scaley, no texture, looks for the most-part like the rest of my skin - but it does not have any pigmentation.   I'm in a monogamous relationship, so I don't suspect any STD.  From my research I would guess it was tinea versicolor.   I had gone to a dermatologist once before for a spot on my chest very similar, it was very simply just a very small spot with no pigmentation.   It was treated with Ertaczo (Sertaconazole nitrate) and resolved in a couple of weeks.    I happened to have some left-over tubes of this cream and I've tried applying it on a fairly consistent basis and have noticed no change.

Followup: if it is indeed a fungal infection like tinea versicolor, will I notice any change in it with treatment?  Will pigment return on its own?  The skin on the shaft of my penis is relatively dark.  

I've attached a photo with a close-up inlayed.

[JMan19802]

I've also tried treating it with an OTC Antibiotic cream as well as Tea tree oil.  

[JMan19802]

Any help from a dermatologist?

[Bhupinder Kaur, MD]

Hello,
Pityriasis versicolor is commonly found on the sun tanned areas on the upper trunk but it is rarely found on the penis. From the symptoms lichen sclerosus and vitiligo need to be ruled out although symptoms of lichen sclerosis at this age are less likely.

Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. As a result, white patches appear on the skin in different parts of the body. Diagnosis can be confirmed by external examination, blood tests to check skin cell count for melanocytes and biopsy of the skin patches.

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.

[JMan19802]

Doctor,
Thank you for your advice.  Visually it doesnt look like what I've seen of vitiligo or lichen sclerosus, but obviously your experience is more than mine.   Its a difficult situation, I know that doctors have seen it all  - but obviously on the penis, there is an embarrassment factor that is making me hesitant to go.   I know that you are obviously unable to make a diagnosis thru the web, but did you look at my photo in its large version.  Its a pretty close-up high resolution shot.  I'm just curious if the visual of the photo makes you lean more towards any certain suspicion of what it could be.

I'm surprised that you say tinea versicolor is uncommon on the penis, given that its a hot humid area.

Warm Regards

[Bhupinder Kaur, MD]

Hello,
Pityriasis versicolor can affect the groins but it is very less likely to affect the penis and cause such hypopigmented spots. I suggest you to get it checked from a dermatologist to confirm the diagnosis.

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 dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.