
What Causes Red Patch On Penis?

I have red patch on my penis. It's been there for past 2 months, there is no pain. I tried applying topical steroids and several things, not helped, it is still there. It does not look like balanitis since the patch is there for long time and there is no pain, more like genital psoriasis. I have attached pictures. Please confirm
Please forward it to DERMATOLOGIST, it needs to be answered by a dermatologist since it has been there for longer duration and expert recommendation is needed
Investigations required in the case
Detailed Answer:
Hello My Dear Sir
Welcome.
I am Dr V XXXXXXX a Sr Dermatologist.
I have examined the pics as well as your details.I will do my best and help you
The patches of the kind that are visible and the description match changes in the skin that are unrelated to infectious etiology.
It is quite often that we come across steroid modified changes and they turn out to be something that needs radical treatment. It would be best for anyone in this situation to aim for accurate diagnosis and then go on to the next step of appropriate treatment.
The possibilities under considerations are Bowen's, Erythroplasia apart from Psoriasis.
Anyone in this situation should consider a hisptopatholoy examination after biopsy from the removed tissue.
In the meantime one can try to keep the part dry and use an antibiotic cream like Mupirocin.
I will be helping you to clear any pending queries and to guide you.
Best wishes from us


You are worrying me with Bowens and Erythroplasia because I heard they are cancerous. They seem to have distinct band. I had talked about this problem to another general physician here online and even asked Dermatologist but he said it does not look like EQ or Bowen's because they have distinct border and rich red velvety color.
This appears more like eczema or psoriasis because it has that feel of shaded skin and white scaling in rest of the area (see first 2 pictures), other saying balanoposthitis that stays long enough due to immune system issues. However ezcema or psoriasis on glans penis tends to have red non scaly appearance on glans penis due to moisture and covered
Why do you think it is EQ or Bowen's. I do have itching and inverse psoriasis in arm pit, severe itching on scrotum and psoriasis itchy plaques on scrotum. I have had this for past 20 years
what are the chances of this being EQ or Bowens. The dermatologist said there is no need to do any biopsy when I saw him, he felt this is more like Ezcema or similar due to shriveled feel of skin, pinkish color and no sharp borders unlike EQ, Bowen's. This looks more diffused pinkish with occasional small red patch which is more like psoriasis, see the picture 1 and 2
Please confirm. You really worried me now
Thanks
Additional details provide useful information
Detailed Answer:
Hello Dear Sir
Welcome with more details.
I would like to assure you that I have seen all your pics, including the first two under magnification and that in your presented details, there was not a mention of Psoriasis elsewhere on the body. When psoriasis is present elsewhere on the body, it makes it more likely that the lesions on glans could also be the same, though not absolutely and always. Moreover, with steroids like Triamcinolone, the powerful anti-inflammatory and vasoconstrictive effect leads to reversal of visible changes in eczema or infections. These lesions in such cases lose their original appearance and can mimic several other conditions. Safety of patient has to be the first concern.
In view of the recent information from you, I would be more inclined to think this patch as a plaque of psoriasis and observe its evolution and presently treat it as a psoriasis lesion but a watch on its behavior is desirable. A psoriasis plaque should respond to Hydrocortisone cream as strong steroids are unsuitable for the delicate skin of genitals.
I am sure you agree with me that Telemedicine has certain constraints. I simply want you safe and well informed, and open you up to XXXXXXX discussion.
With best wishes.


The redness feels different different day, after bath, before bath, sometimes patch look less red, it is hard to figure out. However I read that psoriasis on penis glans do not itch
Please see attached picture picture22, and picture23 on the highly itchy patches. I apply cream, they feel better and then back again. It's been going on for years, they get worse in winter
Picture 22 and 23 match psoriatic presentation
Detailed Answer:
Hello Sir
Thanks for contacting.
I have examined minutely both the pics and these fit into the presentation of psoriasis.
The redness can vary from one climate to the other and even during different times of the day.
Basically, in psoriasis there is formation of new capillaries which increase pinpointed vascular marks.
It is good that the infection part is under control. If you would ventilate the affected areas and keep them dry, it certainly would help in having less of the frightening redness that becomes a cause of worry for anyone.
Moreover, minimum handling is also to be practiced in such cases.Normally psoriasis either does not itch or itches mildly but variations are not infrequent and this generally is not a major criteria for labeling the lesion.
I agree with you that minimum medication is a good thing to practice and raising one's threshold of tolerance is also important since the disease is chronic and needs gentle handling. Medicines like steroids should be reserved for highly deserving situations.
I wish you all the best.
Let me know of any help needed.


So my worry was penis because I read so much information on internet on EQ and all other things and when you said it could be EQ, it just created huge worry.
Please see the first two pics of penis and see small white scale spots
I have attached the two pictures again as picture1 and picture2 that shows some white spots and signs of scales. The redness on penis glans changes all day, looks lot red under light, but less red under day light. The read patches change from one area to another but are not spreading beyond that area. There is no raised borders, crust or pain now
There are also November November10, november 11, that's when I noticed the red patches, and they thought it could be balanitis. These picture picture where I had small ulceration due to infection and lot more red, since then redness is less. I also had lot of burning and pain then, now there is no pain. However the small redness is still there
Please let me know now if you think this is psoriasis and I am trying more natural things like Alo vera, Coconut oil and just not doing anything and I noticed it got better when I stopped bothering about it and watching it too many times. Then I read some article and again started worrying. I would have been fine if I had not read too much on Zoon, XXXXXXX and EQ. I read several articles and that really triggered worries a lot.
Psoriasis is the likeliest possibility
Detailed Answer:
Hello Dear Sir
welcome back.
I have examined the recent as well as previous pics and compared them in the light of information.
I appreciate your concerns for personal health and think that anybody would do that.It is here that the role of someone who has knowledge and experience comes in to play.
For now, relaxing , doing your best not to interfere with process, avoiding steroid of Triamcinolone potency, and using emollients would be the best thing to do while keeping a watch and having pictorial record maintained for future reference is also advisable.
In all probability, your anxiety will settle soon. I want you safe, healthy, and alert too. My best wishes


Thanks for your help
1) so just wanted to confirm there is no need to do any further investigation since you have seen last 2 months and latest pictures and my other psoriasis situation you feel everything points to psoriasis. I have also seen it's possible the patch may remain red for long time and not really cause anything else.
2)
I read over 30-40 articles on EQ and Bowens and personally felt and also dermatologist had said not EQ, as soon as he saw, he said ezcema or psoriasis because of pinkish diffused area and told me EQ tends to have sharp border, fixed area, dark red and not pinkish color. There is small spread of pinkish skin and inflammation beyond the red patches if you see the closely in picture 1 and picture 2
3)
I would appreciate your clear diagnosis because that will put worries to rest since there is no pain, no burning, no crust, no elevation of red area. However I do see stretch marks...what are they ??? can you tell me, typically psoriasis tend to have that wrinkled and horizontal lines..I see them everyday..they look like folds or stretch marks
4)
I want to avoid steroids. It's possible the skin may remain red permanently, who knows.
Thank you
Queries and answers
Detailed Answer:
Dear Sir
Welcome.
Here are the answers as desired
1) so just wanted to confirm there is no need to do any further investigation since you have seen last 2 months and latest pictures and my other psoriasis situation you feel everything points to psoriasis. I have also seen it's possible the patch may remain red for long time and not really cause anything else.
Yes, for now just a need to be observant. Investigations may be deferred.
2)
I read over 30-40 articles on EQ and Bowens and personally felt and also dermatologist had said not EQ, as soon as he saw, he said ezcema or psoriasis because of pinkish diffused area and told me EQ tends to have sharp border, fixed area, dark red and not pinkish color. There is small spread of pinkish skin and inflammation beyond the red patches if you see the closely in picture 1 and picture 2
You are correct. Use of steroids can mask original picture and appearance alone cannot be confirmatory.
3)
I would appreciate your clear diagnosis because that will put worries to rest since there is no pain, no burning, no crust, no elevation of red area. However I do see stretch marks...what are they ??? can you tell me, typically psoriasis tend to have that wrinkled and horizontal lines..I see them everyday..they look like folds or stretch marks
It is closest to a plaque of Psoriasis Vulgaris.
Accentuated markings are due to changes in skin thickness.
4)
I want to avoid steroids. It's possible the skin may remain red permanently, who knows.
Using emollients is better than steroids. Redness is inconstant and less reliable indicator of the underlying process. Staying alert to changes in advisable even otherwise but more so if there is anything that has been bothering.
There is a high probability that investigations may not be required and you will stay healthy and happy.
Best wishes


Picture Jan17-1, Jan17-2
I suspect if there is some allergic response, it seems to get worse some days and look almost normal other days. The redness is lot less. This is why the dermatologist said it could be Eczema based on the pinkness and variation on colors. I don't do any body wash or nor I did absolutely anything yesterday, so why redness is lot less ?
1)
Does EQ/Bowen change appearance this frequently ?. The picture of EQ see well remarked bands and rich red color. The borders are sharp in most EQ and Bowen's and color is lot red, almost cherry red.
Could you please take a close look and let me know. The dermatologist thought it may be eczema, but there is no itching or burning. Or is this some sort of allergic variation.
2)
Why the skin there is so smooth than the rest of the glans penis as it thin plastic sheet wrapped in that area ?.
see the pictures Jan17-1, Jan17-2
Detailed Answer:
Hi
I have seen the attached pic which is labeled XXXXXXX 17-1. It shows significantly less redness. This could be explained on the basis of recovery having set in. Psoriasis is known to show remissions and relapses
In the light of information provided, there is greater likelihood of the patch being that of plaque Psoriasis than other conditions. I have looked closely and my view is that the lesions should not be interfered with and allowed to heal of its own. In case of any adverse development, further investigation need be considered.
When the superficial layers get peeled off, the underlying layers would seem smoother.
Hope this helps
Best wishes

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