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Q. I have a big black spot on the foreskin, but no pain. Is it something dangerous?

Answered by
Dr. Snehal Laul
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Sep 16, 2020

Hi doctor,

I am a 27-year-old male with a height of 5.8 feet, and my weight is 62 kg. I have a big black spot on the foreskin of the penis for the past four to five years. I do not know what it is. And I do not feel any pain.

#

Hi,

Welcome to icliniq.com.

  • Do you have any history of atopy or allergies?
  • Did you contact with irritants or any chemical?
  • Have any history of minor injury or trauma?
  • Did you scratch or rub the lesion? Did you pop or prick it?
  • Allergic reaction to irritant soap?
  • Any chronic illness?
  • Drug history?
  • Any fixed drug eruption?

Please attach the picture of the lesion for a better understanding.

Thank you, doctor, for your reply.

There are no allergies or any drug history. Sometimes in two to three months, I feel itching on the foreskin for one to two days. Nothing else apart from that.

#

Hello,

Welcome back to icliniq.com.

You can try,

Tablet Levocetirizine 5 mg twice daily for seven days (when itching is present).

Avoid scratching of the lesion as it can cause secondary bacterial infection. Keep the penis clean and dry.

Apply Candid (Beclometasone with Clotrimazole) cream at night for seven days (when itching is present).

Fucidin (Fusidic acid) cream at daytime for seven days to avoid secondary bacterial infection.

Maintain proper genital hygiene.

  • Any autoimmune disorder or lichen sclerosus?
  • History of fungal infection in the past?
  • Are you diabetic?
  • Are you hypertensive?
  • Family history of melanoma?
  • Are you sexually active?
  • Do you have itching or burning?
  • Do you have urethral discharge with any pain or irritation?

Do reply.

Thank you, doctor, for your reply.

This is the first time I am consulting for this problem. Can you tell me what this problem is exactly called?

Is it treatable? And how can I get this spot removed?

Is it something dangerous? I am worried about this.

Sometimes in two to three months, it feels itchy and smelly for one to two days maximum, like a little liquid on it.

Do I have to start applying the Fucidin and other creams from today? And please tell me how it can be removed permanently. I masturbate three times a week. There is no family melanoma. But I have red spots on the chest (Photo attached). This creates itching, as I have a lot of dandruff in my scalp.

#

Hello,

Welcome back to icliniq.com.

It is seborrheic dermatitis (chest area) due to Malassezia globosa species (yeast). You can try,

1. Dersil AF (Ketoconazole) body wash or soap like KZ (Ketoconazole) soap for bath.

2. Salicia KT shampoo (Salicylic acid and Ketoconazole) twice weekly and keep it applied for 15 minutes and then wash off (for itchy scalp and dandruff).

3. Apply Pacroma (Pimecrolimus) 1% ointment at night over the chest area for seven days.

4. Apply Ketoconazole cream in the morning over the affected area in the morning (chest region) for ten days.

5. Tablet AF (Fluconazole) 400 mg once immediately.

The penile lesion is a postinflammatory hyperpigmentation mark. Do not worry. Many penile lesions are usually benign. But some requires intervention.

A biopsy is recommended for confirmation of diagnosis. Laser therapy can be done for cosmetic issues after confirmation of diagnosis from histopathology reports. Avoid oil application as it acts food for dandruff. Follow-up after ten days.

Hi doctor.

I am varun. I have asked you about my dandruff and redness on chest area. If you will see the above chat. And i have used the creams, shampoo and medicines as you have advised me. I am not using the shampoo now and the dandruff is coming again. How to get rid of this problem.

I am attaching photos again. Should i continue to use the same cream and shampoo. I have got many red spots on the back side of my body.

I want to know when will this finish permanently. Or do i have to use these product for forever? I want to get rid of these red spots and redness on my chest region and on the back. Attaching photos
# Apply Brevoxyl creamy wash on back 20 min before going to bath for 1 month.

Nadibact cream twice daily or clindamycin lotion twice daily for 10 days(on inflammatory lesion).

Ketoconazole soap for bath for 2 months.

Tab Levocetrizine 5mg at night after food for 7 days(if itching).

Avoid scratching and rubbing of lesions.

Avoid activities which cause sweating .
Avoid occlusion/friction/heat/moisture.

Wear loose comfortable thin cotton wear.

Scalpe shampoo twice weekly for 6 weeks if Dandruff issues.

Discontinue previous medication.

Regards.

Has inflammation on penis reduced??

Recurrent Balanitis??
Hi
I have not used any cream on my penis which you have advised me last time
Because i dont feel any itching there. The big black spot is still there but i keep washing my foreskin everyday.

Do i apply any cream there? Is there any relation with my lesion ( black spot) on penis with my chest region and back side. Red spots? What is the reason of these red spots?

And these redness will finish for forever or not?

The shampoo you told me to use last time i was using that it stopped my dandruff but now i am not using from 1 week so dandruff is coming back again. The scalpe shampoo is more effective than the previous shampoo? And for how long do i have to apply the scalpe shampoo? 15minutes?

I am not advised to exercise ? As it causes sweating?

I am attaching photo again for the black spot on my penis . Its so weird. Have no choice. I am really worried
# It's penile Melanosis.

Treatment is by Co2 laser.

Also Evaluation of lesion Is needed.
Biopsy should to thought of to rule out malignancy.

Sclape shampoo contact period 10 min. and then wash off.

Improvement is seen in lesions.

Previously It was P.cersicolor(superficial fungal infection due to sweating/moisture/heat/occlusion).

Now there are truncal Acneform eruptions seen.

So 1 percent Clindamycin lotion twice daily in morning and evening for 20 days.

Brevoxyl creamy wash 20 min before going to bath apply it on trunk for 20 days.

Ketoconazole soap for bath for 2 months.

Maintain proper genital hygiene .

I can see the genital lesion has also improved.
Great work.

Regards.

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