Q. What could cause a rash on the penis shaft of a sexually inactive 22-year-old?

Answered by
Dr. Shubadeep Debabrata Sinha
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 22, 2022

Hi doctor,

I am a 22-year-old male who has been with the same partner for three years. I work abroad and have not had sexual intercourse with anybody for four months. Four weeks ago, after shaving my genitals, I noticed a rash at the base of my penis shaft, which connects with my pubic hair. I have attached a file of the rash. I did not think much of it; however, four weeks later, it is still there with no significant change. I am currently not on any medication and have had no previous incidents.

Could it be HPV or something else?

I have never displayed symptoms of HPV, and neither has my partner.



Welcome to

I understand your concern.

From the image attached (attachment removed to protect the patient's identity), the lesion appears to be non-specific. There is a possibility of genital warts, and the probable diagnosis is HPV (human papillomavirus) genital warts. However, please note that it is not necessary to have had sexual intercourse with multiple partners to contract HPV. Skin-to-skin touch near the genital level could expose a person. Men who are infected with HPV are at risk for genital warts. The 24-month risk varied from 57.9 % in men infected with HPV type 6 or type 11 to 2 % in men infected with other HPV types. Immunosuppressed patients, particularly those with malignant cutaneous lesions, have a much higher incidence of EV-HPV (epidermodysplasia verruciformis) infection than the general population.

Additionally, if you suspect there could be HPV, you and your partner could get tested for HPV and other sexually transmitted infections, usually co-transmitted. Approximately 20 % of patients with genital warts have other sexually transmitted diseases or infections concurrently. Approximately in case of 30 % of female consorts and 80 % of male consorts had an HPV infection. Hence getting tested both, you and your partner is ideal.

Preventive measures include:

  • Avoid direct contact with the virus, which is transmitted by skin-to-skin contact.
  • Use protection during vaginal, anal, or oral sexual intercourse as viruses may be present in the semen without visible warts.
  • HPV vaccination - Covering all subtypes. HPV subtypes include 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Investigations include:

  • PAP (papanicolaou test) smear.
  • HPV DNA testing.
  • Lesion biopsy (if any).
  • Analysis for HPV.
  • Acetic acid test.

CDC (centers for disease control and prevention) does not recommend specific screening tests for males, but the acetic acid test for genital warts (in females and males) could be indicative. The differential diagnosis would be a non-infectious skin tag.

If the tests are positive, I suggest consulting a specialist doctor, discussing with them, and taking the medicines with their consent.

The Probable causes:


Investigations to be done:

PAP (papanicolaou test) smear.

HPV DNA testing.

Lesion biopsy (if any).

Analysis for HPV.

Acetic acid test.

Differential diagnosis:

Non infectious skin tag.

Probable diagnosis:

HPV Genital wart.

Treatment plan:

To be taken locally if the test results are positive.

Preventive measures:

1. Avoid sexual contact with partner till proven as negative.

2. HPV vaccination - Covering all subtypes

HPV subtypes 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Regarding follow up:

With diagnostic tests.

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