Pigmentation

[Jorge1950]

Dear Doctor,
My young african friend is quite shy about what appears to be a lack of pigmentation on his glans and the area just below. He has had no medical problems. It is a problem that does affect him though. He will not shower with other people (at the gym), won;t even use a urinal when someone else is around, etc. Can something be done about it.. and can it cause any problems later??

Jorge


This discussion is related to Penis discoloration.

[Bhupinder Kaur, MD]

Hello,
It is very unfortunate that a young man has to go through all this. As I have mentioned before vitiligo needs to be ruled out. Diagnosis can be confirmed by external examination, blood tests to check skin cell count  for melanocytes and biopsy of the skin patches.
This can be done by a dermatologist and hence I suggest your friend to consult a dermatologist.

I hope it helps. Take care and regards.

[Jorge1950]

Hi Doc,
1) As far as I am aware of, it is only on his penis.
2) He says it has been there as long as he can remember (born that way?)
3) As you can see, it covers about the top 3 inches
4) He will not consider circumcision (it is a custom here for teenage-boys to be circumsized). As the white patch will then be permanently exposed, he won't hear of it!
5) As far as I am aware of, he is perfectly healthy.
6) If it is unlikely to cause any problems in future, he would rather be spared the problem of spending days at the local clinic and be seen by numerous nurses, sister, etc. etc. before being referred to a dermatologist in a few months.  As he is uncut, he could live with the foreskin hiding this most times?

[Bhupinder Kaur, MD]

Hello,
The symptoms are suggestive of vitiligo penis. It is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin are destroyed. Many treatment options are available but the choice of therapy depends on the number of white patches; their location, sizes, and how widespread they are and the option that is convenient to you. Circumcision or surgical approach can only be undertaken if your vitiligo has not changed in the last year, no response to PUVA or PUVB treatment is there and there is no chronic disease like hepatitis B or HIV.

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 dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.