Brief Answer:
Kindly asked to provide some more information

Detailed Answer:
Hello,

Darker spots can be caused by several causes. If they are flat and not causing any symptoms, penile melanosis is a possible cause. If they are raised then they may be warts generally due to HPV.

It would be helpful to know some more information.
- are you at risk for sexually transmitted infections (casual partners, unprotected intercourse) or have you had sexually transmitted diseases (STD) before?
- have you had tests for STD in the last year or recently?
- do you have spots in other areas of the body or mouth ulcers?
- any penile secretions or urinary symptoms?

Kindly asked to reply and answer the above questions and if possible uploading a picture or two might help better understand the possible cause.

Regards,

Antoneta Zotaj
General and Family Physician

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Brief Answer:
Yes please, pictures would be very helpful

Detailed Answer:
Hello,

Having pictures is very helpful identifying skin lesions so please attach some pictures.
It seems you are not high risk for sexually transmitted diseases so this is reassuring.

No lesions in other areas of the body?

Waiting for your reply.

Regards,

Antoneta Zotaj
General and Family Physician

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Brief Answer:
Detailed explanation below

Detailed Answer:
Hello,

Thank you for uploading the picture. i just reviewed it.

Pigmented lesions on the penis can be caused by different things from benign like penile melanosis to precancer (not yet cancer but without treatment might progress to cancer in some patients) like bowenoid papulosis of penis, to melanoma which is a skin cancer.

In your case, according to the view of the lesions it seems to me more likely to be bowenoid papulosis but the difference between the lesions mentioned above with the free eye is not safe or accurate.
The best way to make the differential diagnosis between the pathologies mentioned above is biopsy. Punch biopsy is most of the times enough (the doctor has a specific machine that "bites" a small portion of one of the lesions and sends it for biopsy. This is easily done with local anesthesia in the office within 30 minutes. Rarely excisional biopsy is needed (removal of all the lesion, it is more invasive but still can be done with local anesthesia)

To conclude I would say that you need to talk with your doctor and discuss the diagnosis mentioned above and what resources he has available to be able to make the difference between them as the free eye examination is not enough and it is safer to rule out more important diagnosis.

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

Kind regards,

Antoneta Zotaj
General & Family Physician

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