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Red scaly ring on head of penis diagnosis help

Doc,

I am 28 male, 6'1" 185 lbs, healthy athletic, no diseases or health concerns.

In the past 10 days I have developed a red, 0.5 inch oval-shaped patch of skin on the dorsal head of my penis (see pics). It doesn't look very dramatic, but the red patch has persisted for more than 10 days without changing and without me disturbing it. It is mostly smooth, slightly red, the skin in that spot appears shiny with a different texture than surrounding skin. There appears to be a border around the area where the redness is more pronounced. No itching, no burning, no discharge, no pain. The skin feels slightly scaly to the touch, is noticeably altered and is not the normal smooth feeling skin of the penis. From my own research, it looks nearest in appearance to a minor burn, ringworm or granuloma annulare. My first thought was it seems to be a fungus of some kind.

The most recent sexual encounter that preceded the red patch was receiving extensive oral sex from a type 1 diabetic. She is known to battle infection such as yeast etc due to long term chronic diabetes.

I took a pill of Fluconazole and have also applied tolnaftate, no effect on the red patch - its appearance remains unchanged day to day.

I will include pictures for viewing, I took the best picture possible but the discoloration is less noticeable than it is to the naked eye. I first noticed the area while masturbating in the dark I felt something odd on my penis to the touch and investigated and discovered it was this small patch of skin.  

Please let me know if you have any ideas what this could be. I am 100% confident it is not "irritation". I have thick strong skin and almost never experience reaction or irritation. I'm the type of guy that can receive a hand job with no lubrication and have zero skin irritation, very tough not prone to redness or skin reactions.
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*Update*

After 2 weeks and twice daily application of tolnaftate, the red patch is vanishing! It's improved dramatically and is hardly visible. The skin appears to be returning to normal!

Helpful - 0
1318109 tn?1292884973
MEDICAL PROFESSIONAL
Welcome to the Dermatology Expert Forum!

A slightly red, shiny penile patch with discrete desquamation (scaly), no discharge, no subjective symptoms, and not responding to anti-fungal therapy, could be manifestation of several diseases including Lichen planus, Lichen sclerosus, or Proriasis, etc.

It is not recommended to treat such a lesion without clinical evaluation done by a dermatologist. She/he should create an optimal treatment strategy for you after taking a medical history and detailed examination. Sexually transmitted diseases and Bowen disease (Erythroplasia of Queyrat) should be excluded.


Wishing You Optimal Health,
Dr Jasmina Jankicevic
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