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Irritation on penis, not sure what to think

Four days ago when going to the bathroom I noticed a rough area on the side of the shaft of my penis. Closer examination revealed a number of small scabs, about 20 or so, most of them linear in shape, about 0.5 mm wide and 1-3 mm long. A few in one area were roughly round and about 0.25-0.5 mm in diameter. The sores were not painful, did not itch, just felt rough to the touch, and gentle pressure got a few to flake off. Pulling the skin tight, the scabs had an almost net-like (but irregular) appearance and I could see a couple of dark veins right under the surface of the skin. The entire area on the shaft of the penis is about the size of a dime.

Over the past few days the scabs have subsided, the roughness has gone down considerably, but is still there. At times you can't even see them anymore, but you can still feel them a little.

I don't ever remember seeing any blisters, erosions, or any other kind of sores appear, and have not had any of the other classic symptoms of herpes. No pain or soreness, no flu-like symptoms or fever, no swollen lymph nodes. I showed it to my wife and she seemed to think it was just irritation of that area of the skin, possibly from excessive sweating, getting kicked by my daughter there (don't recall that happening), or from rubbing against the skin of my testicles where the hair is growing back, since I sometimes keep the area shaved. We have not had sex since the appearance of the rash/irritation.

I had unprotected sex with a woman over the course of about 2 months. We ended the relationship, and the last time we had sex was exactly 6 weeks, 4 days ago, and the first time was a little over 12 weeks ago. I did receive (briefly) oral intercourse from a man, about 11 weeks ago, but stopped it very quickly, and as I recall, herpes infection via this route is seldom heard of. Other than this, I have not had sex with anyone other than my wife for the past 10 years.

Irritation is a good guess, as I had masturbated the three previous days, the last time the day before the scabs appeared, two of those times without lubrication or lotion, but didn't feel any sores or anything. The last time before I did use lotion, but only a little. My wife seems to think that may have been the cause but I just want to be sure. This obviously has me quite worried, even though rationally I don't think that it is herpes because the symptoms are nowhere near consistent, only the presence of very small scabs. I'm not sure what the size of normal herpes scabs/lesions is, to be honest, though. I made an appointment with my dermatologist, but it will be five more days before I can get in.

Is this consistent with herpes?
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Avatar universal
Your advice was spot on as usual. My dermatologist looked at the pictures of the genital lesion, observed what was left of it, and said that it was definitely NOT herpes. By this time there was some spreading of the lesion to the inner thighs, where the skin was broken in places and healing in a similar manner, just not as reddish-brown.

He said the lesions were simply atopic dermatitis, with an opportunistic yeast infection along for the ride. A couple days worth of an antifungal cleared that up, and tacrolimus ointment seems to be healing the rest of the irritation very quickly.

Thanks for the wonderful service and keep up the great work.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
I understood your original description.  The additional information doesn't change my opinion or advice.
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Avatar universal
I guess I should clarify the first paragraph; I never saw sores, only the linear scabs. On further examination, the single ones appear to be mostly from linear scabs where part of it has flaked away. My wife said it looks like scaling, although that doesn't necessarily describe the brown color on them I first observed. Over the course of the day they have almost disappeared, but are still there and noticeable when the skin is stretched out. Maybe they correspond to the wrinkles when it is flaccid?
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239123 tn?1267647614
MEDICAL PROFESSIONAL
You are a better judge than I can be about whether it might just be physical trauma from vigorous, unlubricated masturbation.  The linear distribution of some of the scabs seems to fit with that.  However, herpes is the most common cause overall of unexplained genital sores that lead to scabs.  However, roughness other than the scabs doesn't go along with herpes.

You are doing the right thing by seeing a dermatologist.  If s/he is uncertain about the diagnosis on visual inspection--especially if things are healing up--s/he might recommend an HSV blood test.  But all in all, I'm betting against herpes.

Best wishes--  HHH, MD
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