
Small Open Sores On Penis, Spreading Upward

Lesions seem like Genital Herpes but more information is needed to be sure
Detailed Answer:
Hello and welcome to "Ask a Doctor" service,
I carefully checked the uploaded pictures. There are a few possible causes of the sores, very likely they look like Herpes infection but some more information might help us have a better understanding. I would kindly ask you to let me know of the following:
- for how long have you had the lesions?
- do they hurt, burn or itch?
- have you had unprotected intercourse in the last few weeks or couple of months(are you at risk of sexually transmitted disease)?
- have you had similar lesions before?
- have you tried any treatment, which and have you noticed any effect?
- any of your partner/s have genital lesions or have been diagnosed with sexually transmitted disease?
- do you have any skin lesion on other areas of the body?
Kindly reply to the message and let me know of the above information.
Waiting to hear from you.
Kind regards,
Dr. Antoneta Zotaj,
General and Family Physician


2. The lesions have been totally asymptomatic, the day before the first two appeared my entire penis was slightly painful, but looked normal.
3. My wife is my only partner, we have protected intercourse to avoid pregnancy. She's my only partner.
4. I have never had any lesions on my penis before. I do get 4-5 cold sores on my lip (outer vermilion border) per year. I did get a mucosal cold sore at the same time these penile lesions developed.
5. I took 2 Valtrex, which improved my mucosal cold sore (still red, vesicles are now gone) and may slightly have improved the redness of my penile lesions but I can't tell. I took 2 more this morning. I have this Rx for my intermittent outer lip cold sores.
6. No, my partner has no lesions and never has.
7. Besides the one on the inner mucosa of my lip, I have had a bumpy asymptomatic rash on top of my left had for a couple of weeks, but it is asymptomatic and isn't excoriated, doesn't quite look the same. I assumed it was irritation. The hand rash responded to topical halobetasol.
Detailed answer below
Detailed Answer:
Hello,
Thank you for the answer to the questions.
It is quite reassuring that you are in a relationship only with your wife, so recent sexually transmitted infections can be ignored as a possible cause at the moment.
Still herpes infection is difficult to rule oit as it may activate many years from the first infection and not always the first infection is symptomatic. I would not worry at the moment for it either due to the fact that you are using valtrex. Continuing to use condoms is recommended.
The only thing I would recommend you at the moment is just a local antibiotic cream (mupirocine) 2-3 times a day and to watch how the lesions will behave in the next few days.
Even though eczema or local irritation is possible (very small chance) I would not encourage you to use local steroids at the moment as they may make herpes worse if there is a chance for this to be herpes.
Normally they should disappear in 4-5 days. If they are not improving or are getting any worse it is best to see your doctor.
I hope this answers your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj,
General & Family Physician


Detailed explanation below
Detailed Answer:
Hello,
When the condition is clear you can continue as usual.
Herpes can be inoculated from oral herpes but this is a very rare thing (not impossible though). Oral intercourse increases the risk for oral herpes to infect the genital area.
If you and your wife have not had other partners even previously, then HSV2 is not the diagnosis but if any of the partners has had other partners even many years ago, still HSV2 is likely.
We will have to see how lesions will behave in the next 1-2 weeks. If they last more than 2 weeks in total, it is unlikely it is herpes at all.
I hope this answers your query. Let me know if I can assist you further.
Regards,
Dr. Antoneta Zotaj

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