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Avatar universal

Bruise-like spots on glans penis

About six months ago I noticed that one side of my glans seemed darker than the other.  Upon closer inspection I saw that there are actually several dark, bruise-like areas.  There is one larger spot on the underside of the head and three roughly circular spots (about 0.5 cm each) in a row next to it on the side of my penis head.  

My first impression was that it was a fungal infection; I had a similar grouping of circular spots on my chest about a year before which turned out to be fungal.  I've tried two different fungal creams, which have not made any difference.  I've been to two different Planned Parenthood clinics--the first prescribed one of the fungal creams but said it didn't look like anything in particular.  The second also said not to worry about it but suggested visiting a dermatologist when I asked if the spots could be cancerous.  Unfortunately, I don't currently have insurance so that's not an option.  

I'm wondering at this point if the spots are some type of vascular issue.  The color varies every time I look at them, from just slightly-darker than the surrounding skin (kind of a liverish color) to a darker bluish-purple.  The spots are not raised, itchy or painful in any way.  During an erection the spots are completely invisible--if I'm partially erect I can pick out the spots (which are then significantly stretched out) because I know where to look, but with a full erection they are not at all visible.  Also, if I lightly squeeze the head of the penis so that the affected area fills with blood, the spots disappear completely.  In fact, the color of the spots EXACTLY matches the color of the entire area when engorged with blood.  It's almost like the spots have a permanently higher degree of blood flow than the surrounding areas.  They have not changed since I noticed them but one or two smaller spots seem to have popped up on the opposite side of the glans.

My biggest question is whether or not this is something to worry about (read: cancer).  I have a pretty significant level of health anxiety, so I've been concerned about the possibility of penile cancer.  The second nurse practitioner's suggestion to visit a dermatologist actually made my anxiety considerably worse, even though she didn't personally think it was anything to worry about.  There has never been any injury to the area that I'm aware of and I know the spots haven't always been there but I'm not sure how long they have been or how quickly they developed--I only noticed them when I did because I happened to see my penis in different light conditions that I'm used to, but I do think I had noticed some degree of discoloration in the past that just never really registered.

So what could this be?  Hyperpigmentation? Broken blood vessels? Penile cancer?(!) Thank you very much in advance for your help!
6 Responses
Avatar universal
I forgot to mention: I'm 33 years old and there is zero chance of this being anything sexually-transmitted (I'm in a long-term monogamous relationship).  Thanks again!
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
I cannot confirm anything without examination but it can be lichen planus. Lichen planus is an inflammatory disease that affects the skin and the oral mucosa, and presents itself in the form of papules(flat spots) or rashes. Treatment is available only on prescription and consists mainly of steroids, retinoids, hydroquinone and phototherapy.

The other possibilities are penile melanosis or bowenoid papulosis. In my opinion it would be best to get it confirmed from a dermatologist. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.
Avatar universal
Thank you for your response!  The first nurse practitioner I saw prescribed ciclopirox cream, which she said included a steroid component.  She mentioned that she thought there was some inflammation around the entire glans, so she thought a steroid was appropriate.  The inflammation did go away using the cream but it had no impact on the spots.  Would that rule out lichen planus?  Also, when the nurse conducted her evaluation she was at first shining a very bright light on the area.  With the high-intensity light the spots were not visible at all--it was only after she turned the bright light off that I was able to point them out to her.  I don't know if that means anything.

I read up on your suggested possible causes and I just want to reiterate that the spots are not raised or irritated in any way.  Would a pigmentation issue like melanosis disappear completely during an erection or when the area is engorged with blood?

I don't question that I should see a dermatologist but I'm without health insurance until I'm done with graduate school in May.  In your opinion, does this sound like a condition that can wait to be investigated until then?  And, just for the sake of my peace of mind, is there any way this could be cancerous?  I wouldn't think that a tumor, for instance, would just become invisible under certain conditions.  Again, I know I need to see a dermatologist for an actual diagnosis but my anxiety is sky-high and I would GREATLY appreciate any elaboration you can offer.  Thank you again!
563773 tn?1374246539
MEDICAL PROFESSIONAL
Hello,
Penile melanosis or bowenoid papules do not disappear when light is thrown on them. It does not sound like any penile malignancy or cancer and hence you can wait till May when you can consult your dermatologist and get it examined.

I hope it helps. Take care and regards.
Avatar universal
I have the exact same problem im 15 yo my spots dissapear with light too im really scared that it is something serious please tell me what your dermatologist said i would be very grateful
Avatar universal
So what was ir cause i have the same problem and im really scared
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