Flat White Painless Itchless Blister On Back Of Penis

Brief Answer:
Kindly asked for more information related to the lesion/s

Detailed Answer:
Hi,

Thank you for asking at "Ask a Doctor" service. I went through your query and reviewed the picture
I would like to kindly ask a few questions related to the lesion so I can better address your query.
- for how long have you noticed the lesion/s?
- is it one lesion or several?
- how big is the lesion/s?
- i would like to also clarify what exactly are you referring to in the picture attached, can you describe the lesion/s a little more?
- have you had unprotected intercourse in the last 2-3 months? Do you think you have been exposed to risk for sexually transmitted disease (random partner/s)?
- any genital lesions or symptoms in your partner/s?
- do you have secretions from your penis, any burning sensation with urination?
- how old are you and do you have any other medical conditions?

Please copy and paste my questions to your reply and answer below each question so you don't miss any of them.

Waiting to hear back from you.

Kind regards,
Dr. Antoneta Zotaj,
General and Family Physician

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Brief Answer:
Possible diagnosis and further steps discussed below

Detailed Answer:
Hi,

Thank you for the explanations and the uploaded picture, it is more clear.
Because you have noticed the lesion only for 2 days and it is so small it is best to see on time how it will behave to have a definite diagnosis.
Meanwhile there are two main diagnosis I am considering:

- oil glands which are normal and present in all people but sometimes they may cause small bumps on certain areas of the body and cause what is called Fordyce spots. They are generally not dangerous and do not need any treatment. They might increase in number and other lesions come out.
- genital wart- this would be a sexually transmitted infection mostly from HPV and rarely syphilis. The lesion is so small so it is difficult to see if there are specific characteristics of these infections but if the lesion increases in size will be more distinguishable.

I understand your partner has been checked for sexually transmitted diseases (STD) and was not found any, HPV is not routinely checked when STD check is done and in some cases if the check was with cervical secretions, syphilis is not checked either (it is generally a blood test).

I would say that:
- very likely the lesion is an oil gland that is increasing in size and causing Fordyce spots.
- On the other hand the lesion is so small and it is hard to distinguish it from warts. This is why it might be safer to just have a blood test to rule out syphilis as this is a very important infection, easily diagnosed with blood tests and treatment is available.
- If the lesion grows more information will be available and we should be able to determine if it is a wart and if in doubt the lesion can be removed and biopsied for diagnosis (HPV is associated with cervical cancer in women so your partner will need to have pap smears to make sure all is well)

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Antoneta Zotaj,
General & Family Physician

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