What are my options?

[yikes123]

I'm a healthy 29 year old.  I have had a dark brown/red/purplish patch on the underside shaft of my penis for as long as I can remember and decided to do something about it a year or two ago.  I saw my general practitioner, who said it was a fungus or yeast infection.  I later saw a dermatologist who came to the same conclusion.

We ran blood and urine tests to try and find an underlying cause.  Everything was fine.  I did take many antibiotics as a child though (ear infections), so perhaps that is when it started.

Over the last two years I have been treated with various medications, including (forgive my spelling errors):

lotrisone cream
nizoral cream
nizoral pills
fluconazole pills
spectazole + desonide cream
steroid dosepacks
even an antibiotic I think?
many combinations of all of the above

Most treatments lasted about two weeks.  Would break for a while, go back in, and try another one.

Nothing has worked.  The spot isn't changing or growing, and it doesn't really itch, but I would like it to go away.  The last visit to my dermatologist, he said that I have had it so long that it may never go way / may not be treatable.

This just seems hard for me to believe.  I was wondering if I could get your opinion on all of this.  Is there such a thing as an untreatable fungus?  Does it pose any health risks (the docs here don't seem to think so, and say it is very common)?  Any medications or treatments you might recommend, even from a cosmetic standpoint (i.e. can this be lightened?)?  Do I need to see yet another doctor, and if so, what kind?

Would this pose any risk to a girlfriend?

Thanks for any insight you can provide.

[yikes123]

Hi, I just wanted to say thanks for the consultation.  I got a second opinion from a dermatologist and he basically said my GP was a quack, and this absolutely was not a yeast infection and was in fact just hyperpigmentation and that I could stop worrying about it.

[Alan Rockoff, MD]

The description doesn't sound like fungus, and you've certainly used enough medication to treat any fungus imaginable.  So it's time to conclude that it isn't a fungus.

This may well be just pigment in the skin, which may indeed never go away.  But it certainly doesn't sound as though it has any significance beyond appearance and poses no risk to any partner.  Check with your dermatologist, who will almost certainly confirm these statements.  If there are any creams to change the appearance, the dermatologist will know about them, but if there aren't, you may just have to live with the spot in the assurance that it means nothing.

Take care.

Dr. Rockoff