scared and confused

[justink1972]

Hello doctor,
I am a soldier currently deployed in operation iraqi freedom. I was home on R&R about 2 months ago for a few weeks and like an idiot had unprotected sex with an old fling of mine. A week or so after returning to Iraq i noticed a circular spot on my penis shaft about a nickel in size. It is dark in color sorta of a brownish red. When is stretch the skin there is a blood vessel visible there that is almost perfectly circular like the spot. There is no lesion or sore there however on the right side of my penis head there are now 2 white spots almost like fordyce spots where there appears to be no blood flow. These are only visible at times and usually go away when i become erect or take a hot shower. We are in a combat zone and have limited medical supplies. I was flown to a larger base and recieved some std testing but it was all rapidly done with blood and 2 swabs and some urine was sent off to germany. All the rapid results were negative they tested for HIV, Syphillis, Gonnorhea, and chalmydia. And also looked for white blood cells in my urine and blood. I still have these spots on my penis and am very scared and nervous and its affecting my job horribly and i cant focous anymore for the fear of having some type of infection. My genital are just doestn look the same as it used to and it is bothering me very badly. If you could somehow help ease my mind i would greatly appreciate it. Thank you Doc.

[Edward W Hook, MD]

Hi.  The symptoms that you suggest do not sound at all like a typical STD, something that has been and will be confirmed by your blood tests.  I suspect that what you are experiencing could be Fordyce spots or another benign dermatological lesion or possibly  could be a fungal infection (yeast. jock itch).  Alternatively, you could have one of the infections that we see in soldiers returning from Iraq on other parts of the body and which may have, by chance. "landed" on your penis.  The thing I am thinking about is leishmaniasis, an infection rarely seen here in the U.S. but common in Iraq.  

Bottom line.  you do not have an STD. There are several other alternate possibilities which you can explore one your other test results come back (they will be negative).  This is not something for you to worry about.  

Hope this helps.  Thanks to you and your colleagues for the work that you do on all of our behalf.  EWH

[Edward W Hook, MD]

I can promise you that it is nt HIV.  Fungal infections can be treated with topical antifungal creams.  I suspect there are some availabe in the PX.  EWH

[justink1972]

leishmaniasis that just doesnt sound good.... the spot isnt scaly or scabbed over or anything of that sort its just like the skin had been dyed a darker color and has a vessel around it that is only visible when i stretch the skin. I am sort of reluctant to go back to the aid station for fear of reprimand by my chain of command which already happend the first time i explained why i had to be pulled off the lines and flown to the green zone. This doenst sound like it could be herpes or anything serious like HIV does it???? i just want some closure as to what is causing this and i fear that i wont get that until i redeploy back to the states. Do you have any suggestions for me to share with the doc at the medical center here maybe some type of medication if it could be yeast or a fungal infection????