Small red spots with black/pinhole center on penis (Glans(glands) and Shaft)

Forgive me, I have posted this question on the regular forms but wanted to get professional advice.

A few years ago I had a breakout of some kind, on two separate occasions in which they were pretty close together, of a cluster of small red spots with a black center maybe a day or two after sex. Almost looked like thorns within these red dots or just a black pinhole. I even recall an odor along with this breakout. They did itch slightly but not very painful at all. I want to say that I had a hard time urinating (with no pain) some days prior to these spots appearing. These spots would start to heal and turn into more of a flat, round, shiny, flesh colored circle then disappear all together on their own. I have not had anything like this since (2 years now). I think where the answer may lie is that my girlfriend chronically had bacterial vaginosis.

I cannot recall the actual time frame of the results but I did test for HSV-2 shortly after the break out and the test did come back negative. The physician that saw me didn't do a swab and also was not sure what the break out was after doing a quick exam.

Does this at all sound like herpes? A reaction from the BV? Friction from sex?

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum! Thank you for your question!

Best on your description of lesions main differential diagnoses include Molluscum contagiosum and Lichen nitidus. Theoretically Herpes simplex is an option but you have investigated that already.

However, subjective symptoms (foul odor, difficulties with urination, etc.) make it reasonable to suggest screening on bacterial STDs as those infections can exist asymptomatically in males.
  
In regards to bacterial vaginosis, the transmissibility is not fully understood by scientists. Men are not clinically affected by BV.

And finally, friction would have caused more of diffused redness, and potentially some erosion.


Wishing You Optimal Health,
Dr. Jasmina Jankicevic

[allen77]

Not sure if anyone is going to respond to this but I did see my primary care doctor today and after explaining this he said that my "outbreak" was probably molluscum contagiosum and that it didn't sound like herpes.

[allen77]

Thank you, Doctor. If this was Molluscum contagiosum, would it had been rare or unusual for it to appear and clear up (twice) so quickly? I have read that some people have it for months on end.

As in regards to the bacterial STD's you mentioned (foul odor, difficulties with urination, etc.), what kind of tests should I have been screened for?

All of these things have not occurred again but, I can at least be aware of what it is and what to do if it ever comes back.