Please enlighten me

[thisisafakename]

Hi,
  I have a red spot about the size of a pinky nail just underneath the head of my penis.  It began as a spot of dry skin with a very small scab which flaked off after only a couple of days, but it has been almost a month now and the area remains discolored.  There appears to be a layer of dry shiny skin covering the area most of the time, but right after i get out of the shower the area is much more bright.  The consistency of the skin also seems to be different as it does not quite fold up or wrinkle the same way the rest of the skin does. It has caused me no pain nor has it itched at all.  The last time I had sex was in early January, unprotected with a monogomous partner. I hope this is enough information to at least give me an idea of what it could be.  I am unfortunately not covered under any medical insurance at the moment and can't afford a doctors visit, so any insight would be greatly appreciated.

[H. Hunter Handsfield, M.D.]

You provide a pretty good description of the lesion, both above and in your follow up comment below. While I cannot of course make a specific diagnosis, I agree it doesn't sound like an STD.  Psoriasis seems possible; the penis is a fairly common site.  Do you happen to have psoriasis elsewhere?  If not known to have it, clues are patches of thickened skin with white flaky scale on top, especially of elbows or in the scalp (but anywhere); itchy scalp and prominent dandruff also are clues.  Or perhaps a fungal infection?  Or a skin condition called lichen planus.  Any of several other conditions is possible, and I'm not a dermatologist. You might ask Dr. Rockoff's opinion on the MedHelp dermatology forum (tell him what I said).  But I'm quite sure you don't have to worry about herpes, syphilis, or any other STD.

Low cost medical care is available in most communities, e.g. a nonprofit community clinics. You might call your county medical society and ask about such resources in your community.

Good luck--  HHH, MD

[thisisafakename]

Thought of a few more details to add....
The area is also very smooth to the touch in contrast to the rest of the skin on my penis, and often times has a prominent rim of dry skin.  About a week after I noticed the area I became more curious because it was not going away so I peeled the top layer off, which caused a little discomfort in doing so, but it retured in just a few days.  My main concerns are, obviously, STDs and cancer.  From what I've read I can't seem to find any STD that meets this criteria, but it's still a concern.  My main concern is probably cancer since it's supposed to begin as a painless lesion on the penis.  I know that I should actually be checked out but I'm still in the process of getting medical coverage so I'm hoping I can get any clue as to what it could be in the meantime. Thanks

[HHH,MD]

I should have added that I doubt it is penile cancer, which is very rare.  However, that's one reason to see a provider soon, to be 100% safe it isn't that or something else that could prove serious.

HHH, MD

[nsns]

I had the exact same thing pop up on me and it took awhile to go away. The second time I got it, I used an antifungal cream and it went away much faster. I am pretty sure it was a fungus..


Good luck...

[thisisafakename]

There are a few spots elsewhere that I tend to get dry skin.  The outermost portion of skin on both of my big toes is pretty much always dried and calloused, even though I never really walk around bare foot at all.  I also tend to get dry irritated skin in my armpits.  I'm not sure if either of those are symptoms of psoriasis.  If not, is it possible to have the condition just sort of pop up out of nowhere?  I did read that there may be a genetic link involved and I do recall seeing some of the symptoms on my father although I've never heard him mention the term. Also, is there a way to diagnose psoriasis other than visually?  I'm wondering if there would be a way to diagnose it if I don't have a chance to see a doctor until after the lesion is gone, so I can get some type of treatment for it or be recommended something over the counter. Thanks so much for all of your help.

[H. Hunter Handsfield, M.D.]

You have to see a provider.  Neither this nor any other online source is a substitute for that, and you're never going to know the diagnosis by online research.

HHH, MD