White/grey patches of skin on penis glans(glands)

Hi, I am a 23 year old male, I have a few patches of white/grey skin on the tip of my penis (glans (glands)). I have had the problem for about 4 years. It does not cause any pain, it is really just the appearance. I am still a virgin so it is not sexually transmitted. I first tried Clotrimazole 2% cream which didn't work, I then saw my doctor and they gave me some Betnovate Ointment 0.1% cream which again didn't work. My doctor says it is not causing any harm and is just how it looks, but said I could see a dermatologist for a biopsy if I wanted. I am not sure I want to get a biopsy, but I am still unhappy with the appearance of this problem. Also note I also suffer from Vitiligo on other parts of body(e.g. hands), so not sure if this could be connected. Are you able to tell from the photos I have posted what the condition could be? Or if there is anything else I could try? Any information would be very useful. Many thanks.

[Rohit Batra, MD]

Dear ma123951f,

I have seen the pictures sent by you. It was indeed of great help.

As far as the lesion is concerned it is not completely depigmented as in a typical case of vitiligo. The lesion can be ""Pre-Vitiligo" suggesting that you are develpoing vitiligo lesions which are common on genitals in patient suffering from the disease. Your lesions are asymptomatic suggesting that they are not a fungal or some other kind of infection.

Another condition affecting glans (glands) and having a presentation similar to vitilgo is Lichen Sclerosis Atrophicus in which there is also a slight hardening of affected skin.

A biopsy is a must to reach a confirmed diagnosis and you should get it done for proper treatment especially if there is gradual increase in extent of lesions.

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

Thank you for using MedHelp's "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. Rohit Batra

[ma123951f]

Sorry forgot to write before, here is the picture I posted:
http://img687.imageshack.us/img687/7583/dsc01451s.jpg