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What Causes Lesion On Scrotum With Psoriasis Lesions On Testicles?
Question: Hello, I have one small 4 mm cut like lesion on my scrotum (testicular area). It looks like a fissure (from what I have been reading, a small linear cut). It is completely painless. I just noticed it today. I didn't notice any blisters, etc., before today. When I touch it, I have absolutely no pain. I have had no other signs and symptoms I can think about. I have no fever, headache, etc. I did shave a few days ago, but I don't remember buzzing to close to my balls, therefore I don't think it's that. I have also been diagnosed with genital psoriasis, and I have had psoriasis lesions on my testicles, but I have never experienced this kind of ulcer or fissure-like lesion. I did have unprotected sex about a week ago. Just scared this isn't herpes type 2.
Brief Answer:
kindly upload the pic
Detailed Answer:
Hello dear,
Welcome to HCM.
I have read your query and understood your concern.
As per details, its unlikely herpes. Herpes infection is characterised by fluid filled lesions on erythematous base or erosions associated with burning/stinging sensation or pain. Very rarely or in special situations like diabetes mellitus, patient can be asymptomatic completely.
Sometimes, in psoriasis due to friction with clothing or due to sweating, the characteristic clinical picture can be modified and it can present in different way. In such cases, it may be associated with fissuring.
So, considering the fact that you are already suffering from genital psoriasis, the possibilities of psoriasis are more in your case.
I will advice you to upload a pic of the lesion so that it can actually be visualized and we can come to final conclusion.
I will also like to ask if you had previous episodes of herpes ever?
History of herpes in your partner if you are married?
Kindly upload the pic and get back to me with reply of my questions so that i can help you to my best.
kindly upload the pic
Detailed Answer:
Hello dear,
Welcome to HCM.
I have read your query and understood your concern.
As per details, its unlikely herpes. Herpes infection is characterised by fluid filled lesions on erythematous base or erosions associated with burning/stinging sensation or pain. Very rarely or in special situations like diabetes mellitus, patient can be asymptomatic completely.
Sometimes, in psoriasis due to friction with clothing or due to sweating, the characteristic clinical picture can be modified and it can present in different way. In such cases, it may be associated with fissuring.
So, considering the fact that you are already suffering from genital psoriasis, the possibilities of psoriasis are more in your case.
I will advice you to upload a pic of the lesion so that it can actually be visualized and we can come to final conclusion.
I will also like to ask if you had previous episodes of herpes ever?
History of herpes in your partner if you are married?
Kindly upload the pic and get back to me with reply of my questions so that i can help you to my best.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hello,
I have never had any episodes of herpes, neither type 1 or type 2. My partner wasn't my wife, so I do not know if she has it. I don't think she has it. Do you think it can be syphillus? I had sex with her on April 19th 2014. Again, I have had no symptoms, I can press it hard over the bandaid and won't feel any pain. I didn't see any blisters as well. I have had no symptoms of pain when urinating. I put neosporin on it and covered it with a bandaid.
Is herpes always painful? I keep reading it can be asymptomatic. I read that syphillus causes painless lesions that are chancres? Can it be that? I do have psoriasis lesions right now on my scrotum and I've been taking betablockers and adderral. Every time I take adderal my psoriasis get's worse, so I'm hoping this is due to that and possibly some rough sexual contact, or sweating, etc., like you said.
I have never had any episodes of herpes, neither type 1 or type 2. My partner wasn't my wife, so I do not know if she has it. I don't think she has it. Do you think it can be syphillus? I had sex with her on April 19th 2014. Again, I have had no symptoms, I can press it hard over the bandaid and won't feel any pain. I didn't see any blisters as well. I have had no symptoms of pain when urinating. I put neosporin on it and covered it with a bandaid.
Is herpes always painful? I keep reading it can be asymptomatic. I read that syphillus causes painless lesions that are chancres? Can it be that? I do have psoriasis lesions right now on my scrotum and I've been taking betablockers and adderral. Every time I take adderal my psoriasis get's worse, so I'm hoping this is due to that and possibly some rough sexual contact, or sweating, etc., like you said.
Brief Answer:
Get the blood tests as adviced below
Detailed Answer:
Hello dear,
Welcome again.
Herpes is not always painful. I i already mentioned, it is in most of the cases symptomatic but in very few cases, it can be asymptomatic also.
I have seen the attached pics also. Thanks for the same.
Syphilitic ulcer known as chancre is painless well defined indurated ulcer. To confirm the syphilitic ulcer, doctor needs to palpate and examine the patient completely.
But to me from the pic, its not looking either syphilitic or herpetic ulcer.
If still in doubt , i will advice you following tests for herpes and syphilis. otherwise also , these tests are advisable in case of unprotected exposure.
1) IgG antibodies for HSV 1 and HSV 2
2) IgM antibodies for HSV 1 and HSV 2
3) VDRL in serial dilution for syphilis
These antibodies appear after 2 weeks of exposure.
Till the time, you may apply antibiotic cream like mupirocin 2 percent cream twice daily for 7-10 days. Or if possible for you, visit a good dermatologist so that ulcer can actually be palpated and early diagnosis is possible.
We are always here to help you.
Kindly get back to me with the reports and your dermatologist opinion.
Stay healthy
Get the blood tests as adviced below
Detailed Answer:
Hello dear,
Welcome again.
Herpes is not always painful. I i already mentioned, it is in most of the cases symptomatic but in very few cases, it can be asymptomatic also.
I have seen the attached pics also. Thanks for the same.
Syphilitic ulcer known as chancre is painless well defined indurated ulcer. To confirm the syphilitic ulcer, doctor needs to palpate and examine the patient completely.
But to me from the pic, its not looking either syphilitic or herpetic ulcer.
If still in doubt , i will advice you following tests for herpes and syphilis. otherwise also , these tests are advisable in case of unprotected exposure.
1) IgG antibodies for HSV 1 and HSV 2
2) IgM antibodies for HSV 1 and HSV 2
3) VDRL in serial dilution for syphilis
These antibodies appear after 2 weeks of exposure.
Till the time, you may apply antibiotic cream like mupirocin 2 percent cream twice daily for 7-10 days. Or if possible for you, visit a good dermatologist so that ulcer can actually be palpated and early diagnosis is possible.
We are always here to help you.
Kindly get back to me with the reports and your dermatologist opinion.
Stay healthy
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Brief Answer:
traumatic/ syphilis ulcer
Detailed Answer:
Induration is felt in a syphilitic ulcer. By induration, one means button like feel.
Doctor cannot label any ulcer syphilitic just on inspection. That is why I said palpation is essential.
Herpes is highly unlikely as I said. Neither by your history nor by the pic, its not looking like a herpetic ulcer.
From the pic, its looking like a traumatic ulcer. Trauma can be during sex or as a result of friction as I already mentioned , on underlying pre existing disease, like psoriasis in your case.
So, in short, we are left with two possibilities; syphilis and psoriasis.
Syphilis needs to be ruled out. If you can actually palpate and feel the button like feel on holding ulcer, that possibility can be very well ruled out.YOu have to hold the ulcer from the base and feel it.
The reason why I asked you to see to doctor in person is only to rule out syphilis because it is a treatable condition by single shot of injection penicillin. So I dont want to miss any point cent chance of this disease.
If you have any further query you may ask me.
Take care.
traumatic/ syphilis ulcer
Detailed Answer:
Induration is felt in a syphilitic ulcer. By induration, one means button like feel.
Doctor cannot label any ulcer syphilitic just on inspection. That is why I said palpation is essential.
Herpes is highly unlikely as I said. Neither by your history nor by the pic, its not looking like a herpetic ulcer.
From the pic, its looking like a traumatic ulcer. Trauma can be during sex or as a result of friction as I already mentioned , on underlying pre existing disease, like psoriasis in your case.
So, in short, we are left with two possibilities; syphilis and psoriasis.
Syphilis needs to be ruled out. If you can actually palpate and feel the button like feel on holding ulcer, that possibility can be very well ruled out.YOu have to hold the ulcer from the base and feel it.
The reason why I asked you to see to doctor in person is only to rule out syphilis because it is a treatable condition by single shot of injection penicillin. So I dont want to miss any point cent chance of this disease.
If you have any further query you may ask me.
Take care.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
hey doc,
just wanted to tell you that the wound has healed. i also showed it to another derm doctor who said it wasn't hsv! he said since its healing already, it wouldn't be hsv. that heals in 10 - 14 days. is that true? anyway, they took a swab and im waiting for the results, but he said that it isn't that.
just wanted to tell you that the wound has healed. i also showed it to another derm doctor who said it wasn't hsv! he said since its healing already, it wouldn't be hsv. that heals in 10 - 14 days. is that true? anyway, they took a swab and im waiting for the results, but he said that it isn't that.
Brief Answer:
yes thats true for first episode
Detailed Answer:
Hello dear,
Welcome again.
Thats a great news.
Yes, thats true. In first episode of herpes, it takes around 2 weeks to heal.
I guess you must be relaxed now.
Get back to me with the swab results.
I will be happy to help you further.
Good luck.
yes thats true for first episode
Detailed Answer:
Hello dear,
Welcome again.
Thats a great news.
Yes, thats true. In first episode of herpes, it takes around 2 weeks to heal.
I guess you must be relaxed now.
Get back to me with the swab results.
I will be happy to help you further.
Good luck.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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