Can an HPV wart appear as a small lesion on the foreskin on the underside of the penis?

Hi,

Welcome to icliniq.com.

As per the history and images provided (attachment removed to protect the patient's identity), it does not appear to be an STD (sexually transmitted disease). It appears more like a lymphocele, a temporary lymphatic blockage that suddenly occurs following masturbation or sexual activity. It usually does not cause symptoms and may form bluish discoloration due to bruised veins underneath the skin due to mild trauma post activity. They are harmless and usually subside on their own without any treatment. Herpes, as you mentioned, on the other hand, appears as lumps or sores and is usually painful with redness and discomfort. Since you do not have any symptoms, it may not be an STD or herpes. Having said that, undergoing an STI (sexually transmitted infection) panel test is advised, which will help rule out any STIs that may be done yearly. Biopsy, which you will be performing in another two months, is also a specific investigation for histological testing and a definitive diagnosis. For the time being, I suggest you to follow the instructions mentioned below. Refrain from sexual activities and masturbation till the discoloration subsides. Keep the area clean with lukewarm water. Do not use harsh chemicals or soap for cleaning. Take tablet Ascazin (Zinc Acetate) 50 mg twice daily after food at night for one month. Kindly consult a specialist, talk with them and take the medications with their consent. I hope this helps you out.

Hi,

Welcome back to icliniq.com.

The pictures provided appear much clearer than the previous images. The previous images showed bluish discoloration above the glans penis, which could be a sign of lymphatic blockage and small veins being bruised, which may lead to mild balanitis, which is inflammation and redness of the glans penis. The lesion appears as a wart due to HPV (human papillomavirus). As you mentioned, no blood investigations may be used to diagnose warts. However, a portion of the wart may be tested via biopsy to confirm the diagnosis. As for treatment, strong topical medications are used, which may cause irritation and pain when applied. However, the medications mentioned earlier will help with the current infection and further recurrences. However, I suggest you to follow the instructions mentioned below. Undergo the biopsy for a confirmatory diagnosis. Laser therapy, cryotherapy, or radiofrequency cauterization may be other methods for removing the lesion with direct consultation with a dermatologist. Having said that, HPV warts may appear on and off and can be managed with topical medications or procedures, as mentioned above. You can take tablet Ascazin (Zinc Acetate) to prevent recurrences. Kindly consult a specialist, talk with them and take the medications with their consent. I hope this helped you out. Take care.