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Persistent spot on penis

So I have this spot on my penis and I've been keeping track of it for a few months now and here are my notes. Glad to hear any constructive thoughts anyone has on this...

Penile lesion on the top, between the ringed band and the glans (properly: located adjacent to the ringed band but on the Preputial Mucosa).  It is equal to or slightly greater than 10mm. Glabrous (smooth), slightly shiny (leioderma?), is notably lighter in color than the surrounding skin, is not raised, is notably lack underlying capillary structures (it's like they have disappeared and the surrounding ones bend around the area).  There is defined ring (red, brown, or otherwise) when the skin is loose and not stretched tight.  The skin within the lesion doesn't seem to fold and wrinkle like the rest of the surrounding skin while flaccid.  When completely flaccid the lesion nearly disappears under the normal surrounding folds of skin.  The lesion is first noted by it's lack of pigment compared to the surrounding tissue when flaccid.  The disparity dissipates with erection but still can be noted.  It is not white-ish but does have a pallor about it. Hypopigmentation is notable but it is not strictly "white-ish" in appearance and this is most notable while the penis is flaccid.

Over the course of 6 months is has enlarged to it's current size (roughly 10mm by mm; and generally circular). I am not sure when I first noticed this. perhaps summer of 2021 or earlier.  It has become more prominent since.  It started off less than 10mm and was very circular (annular), however it is now starting to elongate slightly (up and down the penis; distal to base).

To the touch: it is smooth, does not rise or lower to/with adjacent skin, it feels like the skin is thinner or weaker (speculative). Handling creates additional irritation and sensitivity, as does downward pressure of the penis induced by underwear. 7FEB22 - after reexamination the lesion is slightly lower than the surrounding skin, most notable when flaccid.

Treatment: In thinking it might be of the lichen family (planus or selerosus) I am applying Elidel twice daily (morning or noon and always before bed).  As of Feb22, I have done this for one week to no effect.  

Theoretical Possibilities:
- lichen planus
- lichen selerosus
- balantis
- HPV presentation of some kind
- cancerous lesion
- pre-cancerous lesion
-unknown cause

Additional notes: I do not recall having any flaking skin, ulcerative lesion, other discoloration, injury, or other incident where the lesion is. It seems to have come on spontaneously.  Friction from sexual activity would be a likely culprit, however the lesion has persisted for months and there was no one sexual incident I could point to that would be the root cause.

Itching: not really no
Pain: dull painful sensation when consistently pressed upon, handled, or otherwise manipulated; otherwise no pain
Bleeding: none ever
Temperature: same as surrounding tissue
Raised/lowered: generally feels consistent with surrounding tissue; looks slightly cavitated when flaccid
Discharge or weeping: none
Dry or wet: neither, same as surrounding tissue; no scaling, peeling, ulceration, etc. Ever.
Pain when urinating: none
Discomfort: only when handled excessively

After warm shower: flush, extremely notable in appearance, wet appearance lasts longer than other skin even after drying.

Just wondering what the heck this is> my member getting older? Cancer? Pre-cancer? Some long hidden STD that has surfaced? I have tested negative for HIV and do not have any usual symptoms of syphilis (and I doubt a syphilis chancer would last months and never go red, ulcerate, or have an erosive appearance).  I do not have any other skin conditions other than the usual (moles, skin tags, petechiae) and all those throughout my body.  
1 Responses
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207091 tn?1337709493
Unfortunately, despite your great notes, we can't tell you what it is. Only a doctor, preferably a dermatologist, would be able to tell you. It may require some testing, like a biopsy, to tell you for sure.

It's not an STD. No STD gives you a spot like this that never goes away. A syphilis sore lasts no longer than 90 days, and like you said, it's red, open, etc.

It's not herpes - it's not a blister, it's lasted way too long (longer than 2 weeks).

HPV - maybe, except you only have one, which would be unusual.

Even molluscum would be unlikely - you only have one.

Is there a reason you haven't seen a doctor? That's what I'd suggest.
Helpful - 0
I wouldn't use our search to filter anything. I'd use google advanced search and put in site:www.medhelp.org and either Handsfield or Hook (our experts, when we had them) and whatever other search terms you'd like. You might even try DuckDuckGo.

We can speculate for days, and still won't know for sure, right? It could be HPV - unlikely, but possible - and if you wanted to, you could probably find other case studies of unusual presentations of HPV.

You could do the same for pre-cancer or cancer, though penile cancers are rare. I'm sure in all your research, you've stumbled on the numbers for that, right?

What I'm saying is that anxiety often leads to deep dives to find what we want to find, to sort of confirm our fears. You have a long list of possibilities - why settle on cancer?

Has your health insurance been fixed? Just go get it checked. I don't mean to sound harsh, but you can get this resolved instead of waiting months longer. :)

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