Warts / Cysts / Mollusca?

[GuyEndora]

Dear Doctor,

I am a 30 year old male and need clarification with my condition.

I've had 3 sexual partners to date. August 2003 was the last time i had unprotected sex until November 2005 where I had a steady girlfriend. Up until November 2005, I never noticed ANY symptoms of an STD whatsoever and did my blood tests as well as clinical swabs for all major STDs and everything was negative.

At the end of November 2005, after a period of 'dry humping' (she kept her underwear on), I noticed what my family doctor diagnosed as 'skin tags' underneath the tip of my penis, underneath the sulcus/glans. There were two, spaced apart and neither changed in size nor appeared clustered. I heeded his advice and they are still there to this day but have not 'worsened' or spread.

Shortly after that time, my gf andwe had unprotected intercourse and I noticed what can only be described as a small whitehead on the glans of my penis, along the rim of the head of the penis. It was never painful nor scabbed. It disappeared/dissolved but in March 2006 I noticed a small whitehead again along the rim of the head on the penis. It went away after 3 days. I never scratched, touched, or poked at this. Four weeks ago, the area where I first noticed the 'infection' was again apparent with a whitehead. A small whitehead, about the size of a pin, was there. Not painful or 'clustered. But this time when it healed, it left a bit of discoloration - the skin is now lighter in tone. Also, it appears to be dimpled in the center but I cannot say for certain. Just today, I noticed a new little whitehead, size of a pin, in a different area on the head of the penis.

Now, here's the really strange part - when I get an erection, I find the whitehead (filled with pus, I imagine) seems to not be as pronouced...As if the erection helped 'heal' the whitehead. In short, after a few days of erections (no sex), the whitehead 'goes away'....They always heal in 2-4 days.

Ever since the first whitehead, I've insisted on protected sex with my girlfriend. Our sexual activity has lessened and she has said she is clean (but has admitted that past relationships did not involve condoms to any great degree).

I've been checked out by a doctor in an STD clinic after the 1st infection. He said it didn't look like mollusca but it MAY be a wart and to come back to burn it off if it did recur.

Since then I've seen a dermatologist who asked all the usual STD-related questions and my sexual history and said that it may be a cyst. The problem being is just today, when I book a new appt with him in 2 weeks, I know this recent whitehead will be healed/gone!

Please advise as to what you think my next course of action will be. I just want to be properly diagnosed.

Thanks in advance for your time.

[GuyEndora]

Thank you for your comments, Doctor.

I was not trying to be vague. I've always had some degree of acne on my face (nothing that ProActive can't solve) and arms and legs but had never noticed tiny whiteheads on my penis until I became sexually active recently.

*-One thing I should mention is that the whiteheads always appeared 1-3 days after protected intercourse and always on the head of the penis. Are there sebaceous glands there? Is this common? I tried looking for other stories online of men who had this happen. I'm going to try changing condoms and see if it helps.

*-Secondly, the 'dry humping' was very, very painful and I knew I was irritating my skin. The skin tags (kerotosis?) were evident about 3-4 days afterwards.

After my family doctor, doctor at the STD clinc, and the derm told me not to worry, but the problem persisted, I became concerned and thought to post.

Thanks again and I'll try to follow up and take pictures for my derm.

All the best,
GE

[H. Hunter Handsfield, M.D.]

Your description is very mysterious to me; I cannot really picture what you are describing.  And in any case, if 2 providers who have examined you cannot make a diagnosis, I certainly cannot do so by a written description.  But three powerful lines of evidence indicate you don't have an STD:  1) Neither a dermatologist nor STD clinician found anything wrong.  2) Your symptoms don't sound like any STD I ever heard of.  3) You have been at very low risk for STD, and you cannot catch anything by dry humping through clothing.

My advice is to arrange with one or another of your docs to agree to see you the same day if/when the lesion reappears.  In the meantime, don't worry about any STD as an explanation.

Good luck--  HHH, MD