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What Causes A Small Bump On My Penis?

Posted on Thu, 19 Apr 2018

Question: Hi there Dr. Kakkar,

I have asked you a question before about pumps on my penis. I went to see a local doctor and he confirmed your diagnosis and prescribed a cream which took care of the bumps within 10 days. Thanks you very much for that.

Anyways, I had a what you would call a "high risk" encounter a while ago and as a result I keep checking around excessively. I noticed this very small bump (1-2 mm) (around 4 months ago) on the backside of my penis and it has been there since and didn't change or anything. It does not itch or anything as well.

Feeling wise, it is very hard to feel it with my fingers but when I do it feels smooth and like normal skin. Also it appears smaller when I stretch the resounding skin.

I wanted to know if this looks like HPV genital warts to you ?

Thank you very much.

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
Genital Wart

Detailed Answer:
Thank you for uploading good quality images. I can see skin colored to slightly hyperpigmented sessile lesion on shaft.
Yes, it is a Genital Wart/ Condyloma Acuminata - it is an HPV infection.
I suggest removal with Electrosurgery.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Kakkar (16 minutes later)

Dear Dr,

Thanks for the quick reply.

If you can see the nearby skin, especially in this pic (IMG_1043), it looks pretty much similar to the Wart. Are those just smaller warts ?

Whats your stand on HPV ? is it a lifelong infection or, after getting treated, I wont be infections to others anymore ?

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Regarding genital warts

Detailed Answer:
Hi

Yes, it's a diffuse involvement with many smaller warts. I did noticed that earlier.
HPV type 6&11 causes more than 90% of genital warts. However when HPV type 16& 18 causes genital warts there is a small risk of malignant transformation. Nevertheless most of the infected individuals are able to get rid of HPV infection aided by the treatment (surgical or medical) of visible warts. Those which are free of any visible warts for at least 20-24 months are considered free of infection. As mentioned there are medical treatment options too. For such a diffuse involvement I would rather suggest Podophyllum resin application Or Electrosurgery for the bigger wart and Podophyllum resin for the remainder diffuse involvement with smaller warts.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (35 minutes later)

Hi Doctor,

Thanks a lot for getting back to me.

I have done much research in the topic and here are few points that I have:

1- The lesion is kind of "flappy" When skin isn't stretched. I am not sure if warts do behave in this way. It is not firm.

2- The whole area around it is wrinkled (probably for circumcision). In my search, I found two of what I think are similar cases in which doctors didn't think were warts:
https://i.gyazo.com/ef8282daa966b7e4d7aeb40fa59d2363.png
https://imgur.com/a/5hFS6

3- Last time I had any kind of sex was 2 years ago.

4- The lesion looks very similar to this https://en.wikipedia.org/wiki/Acrochordon which is stated to be a "skin tag". Although mine is less firm.

5- Hyper-pigmentation is't confined to the lesion as surrounding skin is hyper-pigmented as well.

6- The lesion hasn't changed in size or spread for almost 5 months now (since I first noticed it).

7- There is only one lesion, which is less common with genital warts.

8- The lesion doesn't have the common cauliflower shape and doesn't have the typical GW medical representation (at least in my un-educated opinion).

Is there any possibility that this isn't a genital wart ?

I guess what I am trying to say is that the"texture" of the lesion looks like "texture" of adjacent skin. In addition to that, the lesion does have skin's usual shine (no lost of luster).

I apologize for stating my own un-educated views on this. I just wanted to know if there is even a tiny possibility that this is not a wart.

Thanks a lot for understanding.

Answered by Dr. Dr. Kakkar (22 hours later)

Brief Answer:
Looks HPV related - not acrochordon

Detailed Answer:
Thank you. Apology for a late reply. I was a little occupied.
Congratulations for such a detailed analysis and insights (the lesion being fleshy and not firm!!)
The site is not typical for it to be an Acrochordon and moreover how do you explain those multiple small lesions in the surrounding area?
This seems like it is HPV related and in fact I would like to keep a possibility of Bowenoid papulosis here which is akin to HPV warts and the lesions are fleshy unlike warts. Bowenoid papules has an irregular wart like surface.
Bowenoid papules usually runs a benign course and may regress spontaneously.
I do recommend removal with either Electrocautery or if not possible, regular follow up at 3-6 months for any signs of progression or regression.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (19 hours later)

Thank you very much Doctor. I appreciate your rather detailed response.

Kind Regards

Answered by Dr. Dr. Kakkar (2 hours later)

Brief Answer:
Thank you for writing to us

Detailed Answer:
Thank you for appreciating. You are welcome.

Regards

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Above answer was peer-reviewed by : Dr. Kampana