A penile lesion is simply defined as any abnormal spot, bump, or change in the skin texture of the penis. Observing any alteration can cause concern, but many causes are non-threatening and common. While most penile lesions stem from benign origins, professional assessment is necessary for an accurate diagnosis to separate harmless variations from conditions that require treatment.
Understanding the Types of Lesions
Healthcare providers use specific terminology to classify skin changes. A papule describes a small, raised bump that is solid and does not contain pus. These often measure less than one centimeter in diameter.
A macule is characterized as a flat area of discoloration, meaning the skin color has changed but the texture remains level. When papules merge or spread to form a broad, raised area, the lesion is then classified as a plaque. Plaques feel elevated and firm to the touch, covering a larger surface area than a single papule.
The term ulcer refers to an open sore where the top layer of skin has broken down, exposing the tissue beneath. Ulcers may or may not be painful and can sometimes ooze fluid or bleed. Understanding these descriptive terms aids in communicating the nature of the change to a medical professional.
Non-Infectious and Benign Origins
Many penile lesions arise from common skin conditions or normal anatomical variations and are not contagious. Pearly penile papules are a frequent example, presenting as small, dome-shaped or thread-like bumps typically arranged in one or two rows around the rim of the glans. They are considered a normal anatomical variant, are not associated with infection, and require no treatment.
Another benign finding is Fordyce spots, which are small, harmless, flesh-colored or yellowish papules that represent ectopic sebaceous glands. These spots are a normal variation that does not need intervention. Mechanical irritation or inflammation can also lead to temporary lesions.
Contact dermatitis occurs when the skin reacts to an irritant like a new soap, laundry detergent, or a lubricant, often causing a red, itchy rash or small plaques. This condition usually resolves once the offending substance is identified and avoided. Other inflammatory conditions, such as lichen planus, may appear as small plaques, papules, or macules on the glans or shaft, sometimes causing itching.
Infectious and Serious Conditions
Lesions can arise from infectious agents or, in rare cases, from malignant changes. Several sexually transmitted infections (STIs) present as distinct types of lesions. Genital herpes, caused by the herpes simplex virus (HSV), typically begins as a cluster of small, painful, fluid-filled blisters (vesicles) that rupture to form shallow, sometimes crusting, ulcers.
Syphilis, a bacterial infection, presents in its primary stage as a single, firm, round, and often painless ulcer called a chancre. This lesion typically heals on its own within a few weeks, but the infection remains and requires antibiotics. Human Papillomavirus (HPV) infection causes genital warts, which are soft, flesh-colored, or whitish growths that can appear bumpy or cauliflower-like.
Infections not acquired through sexual contact can also cause lesions, such as candidiasis, a fungal infection often called a yeast infection. This typically results in bright-red patches on the glans, sometimes with small pustules or a whitish discharge, and is frequently accompanied by burning or itching. It is important to also consider rare but serious conditions.
Penile cancer is uncommon, but it usually first appears as a change in the skin, most often on the glans or foreskin. Early signs can include a persistent, non-healing sore or ulcer, a thickening of the skin, or a reddish, velvety rash that does not go away. Unlike many infectious ulcers, the lesion associated with early-stage penile cancer is often painless, which unfortunately can lead to a delay in seeking treatment.
Guidelines for Medical Consultation
Any new or unusual lesion on the penis warrants a medical consultation, as only a healthcare provider can establish a definitive diagnosis. It is particularly important to seek professional evaluation for certain warning signs. A lesion that persists for more than two to three weeks without improvement should be examined, even if it is not painful.
Rapid changes in the size, shape, or color of a lesion are also a cause for concern and require prompt attention. Warning signs also include the presence of an open, non-healing ulcer or any lesion accompanied by systemic symptoms such as fever, unexplained weight loss, or swollen lymph nodes in the groin.
A diagnosis typically begins with a thorough visual examination and a medical and sexual history. Depending on the appearance of the lesion, the provider may take a swab for viral or bacterial culture, or perform a blood test to check for certain infections like syphilis. If the diagnosis is unclear, a small tissue sample, or biopsy, may be necessary for analysis.