I have painless white bumps on my penile head. Please help.

Question

Hello doctor,

I have two white bumps at the head of my penis. They have been there for at least six years. No pain and discharge, but it is round and hard. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Have you done a biopsy of the lesion? Are they painful or painless? Are you a diabetic? Do you have any previous drug history? Is there any pus or fluid-filled lesion? If hard and painless, biopsy is recommended to rule out malignancy. Is there any sexual history? Do you have any warts? Is there any history of atopy or allergy, such as allergic to irritants or chemicals? Do you scratch or rub the lesion often? Do you have any injury, fungal infection, or balanitis in the past? Apply Fucidin cream (Fusidic acid) twice daily for seven days and tablet Emanzen D (Serratiopeptidase and Diclofenac) twice daily for three days.

Answer 2

Hello,

Welcome back to icliniq.com.

One possibility is hyperplasia of the sebaceous gland (nodulocystic lesion), which requires no treatment. It may regress with time. If a cosmetic concern, CO2 laser, surgical methods such as cauterization, excision under local anesthesia (medical supervision) are beneficial. Avoid scratching or rubbing lesions as it may cause secondary bacterial infection, and it also increases in size. To rule out HPV (human papillomavirus) (wart), acetowhite test, skin biopsy of lesion, detection of HPV DNA, and serology are needed. Biopsy of HPV wart shows mature squamous cells with large antinuclear zone and smudgy nuclei. Spontaneous regression occurs in 10 to 15 percent of cases. Apply 5 percent Fluorouracil cream locally to the lesion for three to seven days and 5% Imiquimod cream three times per week every other night for a maximum of 16 weeks will help (if wart confirmed by biopsy). The variants of genitals warts are small papular, pedunculated, sessile, flat-topped papules or plaques, giant condyloma, etc. Another possibility is molluscum contagiosum. They are multiple, soft, painless, smooth, pearl-like swelling. When acquired through unsafe sexual practices, they appear on the genital area. Each mollusci is open with a needle (extirpation), and the inner side is touched with 30 percent TCA (trichloroacetic acid). So differential diagnoses are sebaceous gland hyperplasia, pearly penile papules, molluscum contagiosum, wart, infective cyst, and malignancy. A biopsy will confirm diagnosis and treatment can be taken accordingly. Which test did you perform with the STI panel? Is there burning micturition or increased frequency of urination? Do you have genital itching or urethral discharge? Do you experience tingling sensation?