Hello
Thank you so much for directing your health query to us.
I appreciate it.

I have gone through the attached picture, and my opinion is that it could be one of the following conditions :

1. Herpes simplex: this is the commonest cause of genital ulceration. Herpes is characterised by recurrent bouts of genital vesicles, ie small blisters, which rapidly break down to form small, painful ulcers. It is highly infectious and usually sexually transmitted. The first episode is usually associated with an acute feverish illness, which may be quite severe. The diagnosis must be confirmed by laboratory tests. Stress or other feverish illnesses may precipitate such recurrences.

2. Syphilis: multiple irregular, shallow, painless grey ulcers, like a snail track on the penis, are characteristic of the second stage of syphilis. A flu-like illness and a blotchy, red body rash usually accompany it. As with primary syphilis, the diagnosis must be confirmed by laboratory tests. It is an infectious STD.

3. Apthous ulcers: these are small, shallow, painful ulcers that most commonly appear in the mouth, but can occasionally affect the penis. Typically, they have a grey centre surrounded by a bright red halo. They occur in crops and resolve without treatment. They are not infectious and their cause is unknown.


4. Molluscum contagiosum: a common, benign, infectious viral disease affecting the skin and mucous membranes. It is a common skin condition in childhood when it is transmitted through ordinary skin-to-skin contact. In adults it may be sexually transmitted and this is probably the commonest cause of penile molluscum in adult men. It appears as multiple, small, dome-shaped papules, often with a central depression or plug. A curd-like discharge can be squeezed from them. It may disappear without treatment, but freezing or cautery may get rid of it. Molluscum contagiosum is a marker for 'unsafe' sexual practices in adulthood and those affected should be screened for HIV

5. Small red or purple spots with a thick, warty surface are probably angiokeratomas. They appear on the glans shaft or scrotum. Most often, they appear on the scrotum of elderly men, though they may be solitary and they may appear in young men. These spots -- known as angiokeratomas of fordyce -- are not infectious and require no treatment.

6. Chancroid, Granuloma Inguinale, Lymphogranuloma venereum - these are all rare causes of solitary ulcers.

7. Certain rare disorders - eczema, Reiters disease, Behcets disease, psoriasis etc present atypically in this manner.

The lesions require examination, palpation and appropriate testing by an XXXXXXX or a Venereal Disease Specialist, in order to confirm the diagnosis.
Please do so at the earliest.

Take care, and feel free to ask for further clarifications.

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