Stubborn, whitehead-like bumps

[Jonsie150]

About 3 years ago, I noticed a small patch of bumps that strongly resemble white heads in the inner fold of my foreskin (I'm uncircumcised). Initially, I thought I perhaps had herpes or warts, but I ultimately dismissed this because 1. I'd never never engaged in any form of sexual act with another person at that point, and 2. the appearance and prevalence of the bumps have never changed much (if they have, the changes have been hard to notice).

I asked my physician about it once, and, without really looking, said that it'll probably go away with proper cleaning. However, I do keep myself pretty clean, and it's still there. They aren't any other accompanying symptoms. They neither hurt nor itch.

I've read up on fordyce spots and pearly papules. I understand that pearly papules appear as a ring around the forehead, and that fordyce spots are like subtle spots beneath the skin, and my symptoms dont seem to really fit into either of these descriptions.

So now I'm wondering what you might think they are. I think it might be relevant for me to say that I have an unusually tight foreskin. Not entirely phimosis, as I can retract the skin for wash in the shower. But the foreskin doesnt pull back when I'm erect. I thought (and this is purely a meaningless self- diagnosis) that perhaps the tightness of my foreskin, accompanied with regular-but-moderate masturbation may have created cysts or blisters or scars. Your thoughts?

[Stephen Liroff, MD]

Where exactly are these? on the underside of the shaft just under the head (glans) and on either side of the frenulum ( the raised "seam" on the underside of the penis as this skin joins the head). They may well be skin glands and therefore of no consequence.
S.A.Liroff, M.D.

[Jonsie150]

i did a little more poking around, and i realized that the patch looks a lot like the fordyce spots some people find at the corner of their lips. so i probably shouldn't entirely discount the idea of fordyce spots. it is, however, perhaps unusual to have a small patch of them, instead of a regular pattern all over the penis (?).

[Jonsie150]

It's not around the frenulum. The best I can describe it is that it is on the foreskin, but I have to retract the foreskin to be able to see it. So it's a part of the foreskin that isn't usually exposed.

[Stephen Liroff, MD]

Most common under the foreskin are condyloma. I would suggest that you see a urologist to make sure that these bumps are nothing more than Fordyce spots.
Given the tightness of your foreskin with erections consider a circumcision.
S.A.Liroff, MD

[Jonsie150]

I understand that only a face-to-face meeting with a urologist can truly clear things up. And I don't want to make you repeat yourself.

But, from what I understand, condyloma is very much akin to genital warts, and I think a few things might suggest its not condyloma...

1. I'd not had any sexual contact prior to the onset of symptoms.
2. the appearance is like a flat patch of whiteheads. not really a growth or hump that resembles a cauliflower
3. symptoms have been very, very stable. meaning the patch hasn't grown noticeably

[Stephen Liroff, MD]

You are correct, genital warts and condyloma accuminata are the same. They are caused by the same virus that produces warts on your hands. Their occurence does not have to be due to sexual activity witha partner. If you have any warts you can transmit them around your own body.
You are also correct in you description that genital condylom usually appear to be cauliflower like in appearance. They can be flat plate like patches also and can occur and not change for long periods of time.
I, who cannot see what you can, have to make a guess at this end and at the same time try to avoid allowing you to be negatively affected by my limitations. Your description sounds very much like fordyce spots, but playing the odds, a skin lesion on the underside of the foreskin has a high likelihood of being a condyloma. Certainly, finding pictures of skin lesions and comparing them visually to yours is most reasonable and does have a high likelihood of being correct AND MUCH BETTER than verbal description.
S.A.. Liroff

[Jonsie150]

Hi again. First, I'd like to thank you for sticking with this for me.

I'm not sure if there are rules against this, but here is a link to a picture I've found on a dermatology website. My condition very much resembles that of the first picture (the one on top. just move your cursor over the image for a larger image). Except my condition is not as spread-out or virulent (again, i have a small patch). The picture says its on the shaft, but it it's seems clear that the man has had to pull back some skin to reveal the spots.

[Jonsie150]

oops, forgot the link

http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=1041715055

[the_garr]

i have the exact thing, small group on the underside of foreskin that I've had  as long as I can remember.  They look identical to PPP pics i've seen on the net and by searching i've found HUNDREDS of other guys that have the same thing but can only find info that states PPP is under the head of the penis.  Can PPP be on the inside of the foreskin as well?  It sounds to me like with hundreds of people with all the same thing and a few that have never been sexually active that its not HPV or condyloma which this looks nothing like what so ever.

[the_garr]

Sry I meant Mine look identical to fordyce spots not PPP  and i have found that they do appear right where I have them so i'm sure thats it. A few sites on the net list that fordyce spots  appear on the inside of foreskin.

[Stephen Liroff, MD]

If your skin lesions appear exactly as those in the derm. picture link, then that is what you have!.
S.A.Liroff, M.D.