Black spots on Penis and scrtum

[CRBob]

I am a mid 50's male currently residing in Costa Rica on a religious mission. Have been here for a little over 2 years. About 3 days ago as I was getting out of my car, I felt a pain at the top portion of the right side of my buttocks. Investigation revealed 2 red blistery looking spots on the upper right side of my buttock right where the 2 cheeks separate. The top spot had what looked like a black spot on it. Didn't itch, just a little sore. Immediately after getting into the house I felt a discomfort in the scrotum and anal area. The skin at the end of the scrotum at the rectum was inflamed and itchy and there was a lump with 2 black spots on it on my testicle sack, just about center between the 2 testicles. No lumps on the testicles themselves, I can feel that it is in the skin only, but definitely a lump and a bit sore and itchy. I have discomfort when I walk. A day later I felt a lump near the head of my penis. Not on the head, but on the ring below it(I am a circumcised male). Just below that, on the shaft the skin was blistered and there are 3-4 distinguisable small black spots. I am married and loyal. Been with my mate for over 30 years, and She has no symptoms similar. At this point, 3 days later, the sores on my buttock feel similar to a cold sore one might have on their lip. Painful, and uncomfortable, they do appear to be getting better however. The problem with the lump on my sac continues as do the spots on my penis. The pain at the lump on the ring below the head of the penis stings like when the flesh has been scratched. Obviously I am a bit concerned, and would appreciate a response as soon as you can get one to me.

[allenc]

Recently I have notice 2 small bumps with a black spot on it. It is at the bottom of my penis right at the scrotum. They are not painful in any way but the spots do seem to be growing. I am 41 years old and have been married for 6 years. I would appreciate any help and knowledge you could give me in this matter.  
To:

[allenc]

Recently I have notice 2 small bumps with a black spot on it. It is at the bottom of my penis right at the scrotum. They are not painful in any way but the spots do seem to be growing. I am 41 years old and have been married for 6 years. I would appreciate any help and knowledge you could give me in this matter.

[Kevin Pho, MD]

Tough to say without seeing the lesion in question.  I would be screened for a variety of infections - no matter how little the risk.  This can include a urinalysis as well as urine tests for gonorrhea and chlamydia.

The prostate should certainly be looked at.  A digital rectal exam to evaluate for any tenderness or enlargement can be considered.  Any prostatic fluid that is expressed via prostatic massage can be sent off for culture and analysis.  

If there are scrotal masses or lumps present, you can consider a scrotal ultrasound for further evaluation.

I would discuss these options with your personal physician.  

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.
Medical Weblog:
kevinmd_b