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What Causes Painful Red Spot On Penis?

Posted on Mon, 2 Mar 2015

Question: Hello,
I'm quite embarrassed to be honest but I couldn't think of any other solution. I'm a married man for 8 months now and I am currently in Thailand with my wife for our honeymoon. 3 days ago I've noticed a non painful red spot on my penis and I've never seen something like that before. I'm a healthy man and hygienic regularly. I don't know what it is and I'm starting to stress about it because I'll be back home only in two weeks, and I don't really want to go to a doctor over here in the Islands. For the last 3 years I didn't have sex with someone else except my wide. I have no allergies. Please help, thanks.

Answered by Dr. Shahid Hassan (20 minutes later)

Brief Answer:
It is Lichen Planus and not sexually transmitted

Detailed Answer:
Hi, Welcome to HCM,
You are suffering from lichen planus.
Lichen planus is a inflammatory, autoimmune disease that affects skin, nail and mucosa(oral and geniitalia).
It presents as small, flat topped, polygonal pink or purple lesion. At glans the lesion is non itchy.
Nails become thinner, ridged and grooved, they may sometimes shed or stop growing. Your nail features are classical due to lichen planus is also visible.
Lichen planus is not infectious and is not a sexually transmitted infection.
Enjoy your honeymoon without any fear.
Hope this is helpful.
Thanks

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shahid Hassan (10 minutes later)

Thank you Doctor XXXXXXX
I understand what you're saying, but I have this nail fungus for almost 20 years and nothing has ever displayed on my penis. This Is the first time that I see something strange on my penis. Yes I have fungus in my nails, fingers of feet and hands, but nothing ever looked different on the penis, it always looked normal, never saw a leison.

Answered by Dr. Shahid Hassan (11 minutes later)

Brief Answer:
It is due to lichen planus not fungal infection

Detailed Answer:
Hi, welcome again,
No, your finger nail condition is typically of lichen planus and lesion on glans is also of lichen planus.
Onychomycosis (Fungal infection of nail) causes fingernails or toenails to thicken(Your nails are thin not thick), discolor, disfigure, and split.
Lichen planus can be diagnosed clinically, although biopsy is helpful to confirm the diagnosis and is required for more atypical presentations only.
Lichen planus affecting mucous membranes and nail are more persistent and resistant to treatment.
Hope you clear your facts.
Thanks

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shahid Hassan (33 minutes later)

Ok Doctor I understand, but let me get one thing straight because I'm kind of confused at this point. What does my nail condition has to do with the red spot on my penis? I'm 28 years old and have lichen planus on my nails for 20 years but I never had anything on my penis, never saw a sign of Lichen planus on it, it was always clean and looking normal. So where did that red spot come from all of a sudden? If you're saying it's because of lichen planus than ok, but why did it pop out of nowhere on my penis after 20 years of nothing? Excuse me if I'm bothering you, but at a moment of momentary panic I payed a big amount of money for this application and I want all my worries to be cleared. Again I'm pointing out, never saw anything weird on my penis until 3 days ago. Again thank you sir.

Answered by Dr. Shahid Hassan (31 minutes later)

Brief Answer:
The lesion may appear abruptly

Detailed Answer:
Hi,

Although classified as immune mediated disease, the exact etiology of lichen planus is not known.
Approximately 10 percent of patients with lichen planus present with nail variants.

The nail lesion develops slowly but the rash appears abruptly, and usually lasts for several months.
As it is a immune mediated condition more than one parts of the body may also be affected, including the mouth, nails, scalp, vulva, vagina, and penis.
Involvement of more than one part supports the diagnosis.

I would suggest that to confirm the diagnosis please visit a dermatologist at a nearby hospital in your country and get examined. Biopsy of the lesion will confirm the diagnosis if doubt is there.

Hope this helps.
thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shahid Hassan (35 minutes later)

Thank you Doctor. Is there any reason for it to appear all of a sudden? And will it disappear by itself?

Answered by Dr. Shahid Hassan (19 minutes later)

Brief Answer:
resistant to treatment

Detailed Answer:
Hi,
Cutaneous lichen planus may resolve spontaneously within one to two years, although lichen planus affecting mucous membranes may be more persistent and resistant to treatment. Recurrences are common, even with treatment.
Symptoms can appear suddenly, or they may gradually develop, no reason has been mentioned behind this.
Treatments includes Super Potent steroid for topical application.

If you have any other query go ahead. In case you have no more questions, please close this discussion and review.
Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shahid Hassan (35 minutes later)

The nails are thin because I trimmed them with a nail file, made them real thin, they look ugly if I don't do that you know, a sort of a manicure. What are the side effects of taking these steroids? And out of curiosity, if my nails were not visible in the photo I attached, would have your diagnosis be the same?

Answered by Dr. Shahid Hassan (4 minutes later)

Brief Answer:
Yes

Detailed Answer:
Hi,
Nail lesion is supportive only. Penile lesion is clinically of LP. Go for dermatopathology for confirmation.
Steroids have a lot of side effect. Apply only under supervision of dermatologist and taper it according to his advice.
Thanks

Above answer was peer-reviewed by : Dr. Prasad