skin irritation on shaft

Dear Doc,
About 2 months ago i developed two areas on the shaft of my penis that were very red (maybe dime size but more oblong).  They are not bumpy and the areas are whole, NOT made up of little areas clumped together.  I have ceased all sexual activity since this started but have continued to masturbate (less often).  Almost immediately they seemed to scab over or get a hard layering on top but if i masturbated it would often become red again and bother me.  They dont really hurt unless i rub them.  Since they have scabbed over they tend to peel.  The peeling doesnt stop though, once it peels it might not be a hard layer but it still peels again and again as i guess another layer of skin is dying.   Sometims the dry skin of the scab/ dry area will break and it has bled  a little from that area.  Again, the only time it hurts is if i had masturbated from the frictional contact.  At times when i have let it take its course and the scabs have mostly come off it will itch quite a bit.  At first i thought it was herpes but it doesnt seem to be taking the normal course especially since it has lasted this long and its just a red area as well as the constant skin flaking/scabbing.  What are your thoughts?

[Kevin Pho, MD]

Without seeing the lesion, it would be tough to say.  I certainly would consider herpes.  This can be further evaluated by taking a culture of the lesion, or doing a blood test to evaluate for herpes serology.

With any genital lesions, I would also test for other STDs, such as gonorrhea, chlamydia, and syphillis (syphilis).  A urinalysis to evaluate for UTI should also be considered.

If STDs have been ruled out, other possibilities would be dermatitis or a fungal infection.  These can be treated with topical steroid creams or an anti-fungal cream respectively.  You may want to consider a dermatology referral for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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