Penile Cancer?

Hello,
Im a 30 year old south asian male, STD free, with previously diagnosed phimosis (treated with circumcision 2 years ago) and BXO (treated with steroids).  No other medical issues and no other derm diagnoses.  Over the past 1 year (one year post circumcision and steroids) i have developed 4 hyperpigmented macules on the glans (glands) penis.  one of the four are located inferior to the meatus (where the BXO was previously) and extends upwards to surround the meatus.  They are completely asymptomatic.  I was given a course of steroids x 4 months which hasnt really made a difference. Ive discontinued this now.  Any ideas?  BXO is a premalignant disease, is it not? Im trying to get in to see a dermatologist but have recently moved cities and trying to find a GP to make the referral.  Extremely worried this is a malignant transformation.

[Bharat Chawda, MD]

Dear nonce ,

You have been treated in the right direction regarding BXO and phimosis till now. The initial treatment is topical steroid and if not responding then circumcision is rightly done as it was done in your case.

As far as malignancy is concerned, there is a very slight possibility of BXO turning malignant. The most common malignancy seen in such cases is squamous cell carcinoma, which usually appears as a small erythematous raised lesion (not a macule). Yet it is good to rule this out with a local biopsy of the lesion under the meatus. Early detection is always good for easy treatment.

What you see may be a benign junctional mole (asymptomatic flat dark black mole).

It is commendable that you have realized the importance of following up with such lesion and you wanted to do something about it. It is important to get an initial local examination by your GP and get an appropriate referral.

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

Thank you for using MedHelp ‘Ask An Expert’ Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Bharat Chawda