This question was answered on Thu 29, Apr 2010 01:46am by Dr J Singh

I have a few small brown spots on my penis and near the base. some are slightly raised and none of them turn white when vinegar is applied to them. There are no clusters, just randomly located. I have had some for a while, but the more I have been thoroug

    
Asked by hasquestions (Male; 23; Kidney Disease ) on Thu 29, Apr 2010 01:03am

I have a few small brown spots on my penis and near the base. Some are slightly raised and none of them turn white when vinegar is applied to them. There are no clusters, just randomly located. I have had some for a while, but the more I have been thoroughly inspecting myself I have found a few more. They don't hurt and are dry. I probably shouldn't have, but when squeezed with my finger nails, like a pimple, they can be removed. What might this be?

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Answer by Dr J Singh  on Thu 29, Apr 2010 01:46am:

Hello, Welcome to the forum. It is very difficult to precisely confirm a diagnosis without examination and investigations in dermatology and I am enumerating the possibilities that can be there for such spots. You have mentioned that some of these brown spots are raised. If they are flat then the first possibility that comes to my mind is of genital melanotic macules. In this the lesions vary in color from tan to brown to dark brown, and they have irregular borders and skip areas. You cannot remove them at home. Cryosurgery using liquid nitrogen and laser are the main treatment modalities. Although there are many skin creams like hydroquinone and salicylic acid, but their use needs prescription .The other possibility for flat spots is post inflammatory hyperpigmentation caused by drugs or 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. Now enumerating the causes of dark and raised spots ( papules), it can be due to Fordyce spots which are ectopic sebaceous glands which are pale colored and that may appear on the shaft of the penis. They are non-infectious and a natural occurrence on the body. Their treatment spots includes CO2 laser or electro desiccation, TCA chemical peels (temporary treatment), diathermy or laser vaporization. The second possibility is of syringomas which are benign bumps caused by overgrowth of cells. Treatment of syringoma is by electrocautery , cryotherapy, laser or surgical excision. The third possibility is of Bowenoid papulosis which presents as pigmented (red, brown, or flesh-colored) papules with a flat-to-verrucous surface and may be linked to HPV. Treatment is by local excision, electrodesiccation, cryosurgery, laser surgery, and use of topical retinoic acid, podophyllum resin, and topical 5-fluorouracil. The fourth possibility is of angiokeratoma which are blue-to-red papules with a scaly surface located on the shaft of penis. The fifth possibility is of genital warts, skin tags or any mole being turning into a melanoma. Last but not the least it can be due to mollsuscum contagiosum which presents as multiple, small, dome-shaped papules, often with a central depression or plug. My sincere advice is to consult a dermatologist and get a skin biopsy done because treatment is diagnosis specific and it is through examination and skin biopsy only that we can make a precise diagnosis. I hope it helps. Take care and please do keep us posted in case you have any additional doubts. Kind regards. I am forwarding you a site which gives a pictorial representation of some of these: http://www.skinsight.com/searchResults/adult_Male_Anogenital.htm

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Comment by Dr.Kokil Mathur on Thu 29, Apr 2010 07:08am:
Hi! Dr Anand has replied in detail to your post and you can discuss this with your doctor. These could be pearly penile papules. They are small lumps of roughly the same size and shape. They are in a row around the margin of the head of the penis, and can be seen when the foreskin is pulled back. Also these can be present along the shaft and base of penis. Though the name suggests that they are white, most are flesh colored. Also one can easily nip them off. At your age, I am personally more in favor of these as a diagnosis, though without examination it is difficult to say for sure. Most of these will disappear with age and should be left alone. Please do not squeeze or nip them off. It is difficult to comment beyond this at this stage. Please consult a dermatologist for confirmed diagnosis. Please let me know if there is any thing else and do keep me posted. Take care!

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