Prostatitis and Angiokeratoma

[Terrified5]

Dr. Stephen,

I had a severe lapse in judgement about 45 days ago.  I received brief protected oral sex.  She orally put the condom on me.  As background, I had wrestled with fear, anxiety, and guilt.  Two days post exposure, I experienced a "flu-like feeling" and significant fatigue for 3 - 5 days.  Subsequent to this, I had experienced periodic chills, nausea, general ill feeling, trouble urinating, frequent urge to urinate, and occasionally "tingling" in the penis.  After discussing exposure risks, etc., I am being told that most of this is based on my anxiety and guilt, etc.  

However, here are my concerns that you could possibly shed some light on.

On Dec 1, I noticed some very small < 1mm slightly raised bumps/spots on my coronal ridge of my glans.  On one side was 1 lone purplish dark spot.  On the other on a purple bruise-like band, I noticed 2 - 3 other raised dots.  On closer inspection the purplish bruiselike margin may be tiny purple spots.  On of these spots seems to change from a deep red to dark purple/black depending on the level of "engorgement" of the penis.

The clinic doctor that conducted my testing for stds said that they "didn't seem to look herpatic" and that they would look like they had pus.  The spots I have are non-tender.  However, I am concerned that they could be herpes or warts even though I have been told that it was not likely.  The clinic doctor thought these might be angiokeratomas.  However, based on my readings, this would be an unusual presentation on the glans.  Given that they appear to be for the most part unchanged since Dec1. (Some of the purplish background has seemed to fade a little.)  I am wondering what they could be.  

I also concerned as I have experienced symptoms of prostatitis for about 35 - 40 days.  Within the last 5 days, the symptoms seem to be subsiding.  (I had a rapid test done for UTI and it came back negative.)

Therefore I am concerned about these and wanted your feedback.

Thanks.

[Terrified5]

Thank-you Dr, that is the direction I was heading.

While your comments have provided some assurance along with the others on the std forum, as the disclaimer states, the forums shouldn't be a substitute for actual healthcare.

I appreciate the support you and others have provided.

Thank-you.

[Stephen Liroff, MD]

If you pursue this, see a dermatologist.
S.A.Liroff, M.D.

[Terrified5]

Dr., the bumps are largely unchanged for last 4 weeks.  Beyond the 3-4 larger bumps/papules, the purplish band may be made up of tiny bumps of <.25mm-.5mm as some appear to present themselves as such when the area is engorged and recede when not.

No ulcerations or sensitivity.

What type of doctor should I seek, a dermatologist or urologist?

Could this be Lichen Planus? or Balantis? beyond beginning stages of angiokeratomas.

[Stephen Liroff, MD]

Your penile findings are not related to your other symptoms, as I see it. As to what your penile findings are is not evident from your description and are probably normal.
The glans penis has a very rich blood supply and any vessels near the surface may appear more prominently with engorgement. Angiokeratomas of this area are, as you noted, qiuite rare, and what you have maybe an early change leading to a more obvious form of this. No treatment is needed unless this becomes a definite problem.
S.A.Liroff, M.D.