Patient: In my mid twenties I had a few similar (to photos) bumps on my penile shaft that I was able to sort of “scrape” off. I have always had a ton of Fordyce spots on my scrotum and up a good portion of my shaft. About 8-10 years ago I started shaving my shaft (gets very hairy) right up to the tip and down into the scrotum. I shave both directions and have to go against the grain (from tip to base) to really get rid of all hair. Since I started shaving I started to notice a small smooth, slightly raised mark on the side of my shaft. It seemed to get a little bigger over time as I shaved and often some of the bumps (Fordyce) would bleed a bit. I just assumed these marks were from shaving for years as they never really went away. One near the base got a bit raised and rough after shaving so I panicked due to their appearance and tried to self freeze the raised one and the old ones on the side (over the counter dr. school’s). Seems like all I accomplished was discoloration of my skin and the rough part did go away. I tried the white vinegar test a few times and none seem to turn white. I have been married for 15 years and have not been with anyone else but my wife for over 17 years. I have an appt. with my derm., but not until December. Again, I have some variation of these bumps for at least 10 years… may not have noticed them prior due to the large amount of hair on my scrotum and shaft… and also had a few in my mid-twenties (I am 45 now). Most (even larger smooth raised areas have/had hair coming out of them). Not sure if these bumps are related to repeatedly shaving over the Fordyce spots… maybe Molluscum Contagiosum or Sebaceous Hyperplasia related or genital warts from HPV. I have attached pictures (in picture with ring, not shiny rounder bump to right above flat bump). Another doctor stated that they may be HPV sores or Fordyce’s and that I should get a swab test culture… I was under the impression that there is not actual swab test for men regarding HPV, just women? Thank you.
Symptoms: They are not painful and do not itch.
Doctor: Hi.Thanks for your query and an elucidate history along with very clear pictures.Read the history carefully and unde rstood your concerns.My thoughts and explanations are as follows.The lesions as seen in the pictures you have provided look to be sebaceous hyperplasia with scarification:The reasons:Classical pictures.Hair growing out of the most of the lesions.Scarification is noticeable.Does not look like classical HPV.History of shaving, freezing,Confirmation can be had only by an excision biopsy, hence request your Doctor/s to get one to get the confirmed diagnosis and proper management as per the report of histopathology.Yes, there is no proved way to get the HPV tested on the male genitalia. Please feel free to ask for further relevant queries and give feedback too.
Comments / Follow Ups
Patient: Thank you for your response. I will follow up with my doctor. If these “bumbs” do turn out to be HPV related… is it possible that I could have contracted HPV in my twenties and for it to come back so many years later? I have had the flat “bumps” for years (one for at least 5 to 8 years)… is this length of time possible for a HPV “sore or lesion”? Could the bumps/scarring be related to shaving? I have also included a few more pics, sorry for this, the more I look and read on internet, the more I get anxious. Just wanted to show the same view as prior pics from different perspective and extent of Fordyce bumps and hair on shaft to goes all the way to head of penis (not as dense though), which leads me to the two new pics just under head of penis one regular and one enlarged… this bump was shave over for years, but never frozen. What are your thoughts of new pics? (it won’t let me add the new pics… not sure why?
Patient: Here are pics from last comment.
Doctor: Thanks for your detailed feedback and the new set of pictures.
HPV could have contracted a long ago and can manifest anytime in life. The natural history of HPV is never certain and the pictures are not uniform for all patients, hence confirmation is wither by the classical fleshy appearance and by the histopathology reports alone.
Anything is possible with HPV related lumps as you have asked for.
Shaving is a repetitive injury can could have caused scarification over the already not so normal skin.
Seen the lesions on the shaft, the usual and the enlarged one and the lesions on the shaft look more of Lichen.
This again is the importance of a biopsy and histopathology confirmation.
Please stop reading on internet as the material per topic is huge and many times can appear be contradictory.
I hope this answer helps you further. Please do not get confused or anxious, be certain by the ways explained above.
Patient: Ok, thank you. I have an appt. with my family Dr. this afternoon. I will let you know what she thinks so I could have two minds assisting me. I will not read further about this issue.
Doctor: Great. Please give me the feedback what your Doctor thinks.
Patient: Hi, met with my doctor yesterday. She used the terms Lichen and striations. She also mentioned Bowen’s Disease. She is having her office schedule me an ASAP appt. with a dermatologist for a biopsy.
Doctor: Lichen as mentioned above.
Biopsy alone can give confirmatory diagnosis.
You may please give the follow-up as a fresh input/query and give reference ID 516225
2 follow-ups are allowed per query. Please ask a fresh query.
Patient: ok thank you, I will
Doctor: You are most welcome .