Doctor – I am hoping you can help me. About two months ago I noticed a white thickening under the crown of my penis, on the right side. At first I thought it was friction from masturbation because it was sore and the area around it was red. I have noticed that it is now spreading slowly but doesn’t hurt too much unless I have been active. The “bump” is typically white or fleshy in nature and is somewhat hardened. I do have psoriasis, however, it does not flake or scale. In addition, I have treated it in the past with Neosporin and now OTC PolyBactrin.
I am sexually active and an otherwise healthy 29 year old. I am absolutely terrified that this is an STD. Is this something that I need to see a doctor for or visit a sexual health clinic?
On this forum, we don't examine posted clinical photos. We are not dermatologists, and directly assessing physical anomalies comes too close, in our view, to practicing medicine from a distance.
The penis is a very common site for psoriatic lesions, so that may be a consideration here. That said, I agree your description is not typical for psoriasis. The other thing that immediately comes to mind for a lesion that is "fleshy", somewhat "hardened", and slowing growing is a genital wart. But any number of other conditions also could be responsible. For the most part, most (including genital warts) are not at all serious; and I very much doubt this will turn out to be syphilis or any other STD.
You correctly summarize exactly the correct next step: get professionally examined. Your profile doesn't say where you are -- but a "sexual health clinic" would be ideal, such as your local health department STD clinic or a Planned Parenthood clinic, or their equivalents in countries other than the United States. Or, having psoriasis, you probably have a dermatologist -- in which case he or she would be an excellent option.
Perhaps I'll have additional comments or advice, if you would like to return and let me know the outcome after you have been professionally evaluated. But until then, it seems pointless to speculate further.
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