painless tiny red spots on glans penis

[concerned7]

Last Sun I noticed tiny red bumps (painless) on the glans penis that within a few days spread further to junction b/w glans and shaft. It started around 2 wks ago as a tiny red bump (painless) at the tip of urethra, and it was prominent during an erection. I thought it may be normal, but when I noticed red spots, I became worried. The spots are only visible if looked at closely. I think it may be liked to a previous infection 3 weeks ago when I had pain for couple days from a lesion that looked like a whitish pimple b/w the frenulum and sulcus of penis, and it was painless afterwards. I consulted a physician, and she suspected either chancroid or syphilis so prescribed tenutan and mupirocin. A swab test and VDRL test came back negative for bacterial growth, so she then suspected perhaps a herpetic lesion bc I mentioned that I developed a couple pimples b/w lips on my face the same week, which she didn’t get a chance to see, but felt may have been herpetic lesions. But she was unsure about this because the lesion on face did not appear the same as red spots on penis.  She prescribed me acyclovir to clear the herpetic lesion, and doxycyclin in case these spots had recurred due to improper healing of the lesion bw the sulcus. Its been about a week, and I’ve observed no improvement.  If 2 tests for bacterial infection came back negative, and the lesion on face and penis don’t match up for herpes infection, then could it be a fungal infection such as trich?  Or can allergies cause this, such as cleaning with shampoo? I had a cut on frenulum mid Dec if there is any connection.

[H. Hunter Handsfield, M.D.]

Herpes is the most common cause of open genital sores or pimple-like lesions. Syphilis is much less common, but highly variable from one part of the world to another.  Chancroid is rare everywhere.  I cannot judge between these possibilities for your original symptoms, except of the basis of statistics, herpes seems the best bet.  But various non-sexually transmitted conditions also are possible.

However, no STD causes 'tiny red bumps' as you describe the present problem, and both the negative tests and lack of response to treatment further indicate it isn't an STD.  Trich does not do this.  I suppose it could be a yeast/fungal or allergy.

Bottom line:  Follow yp with your doctor, or consider a second opinion if not sure about her expertise in this area.  A dermatologist would be a good choice.

HHH, MD

[TomWitty]

A related discussion, Help Doc! was started.

[shail812]

A related discussion, re:lesion on glans was started.