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Skin discoloration on the penile foreskin. No pus formation. Is this Balantis or Lichen sclerosis?

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General & Family Physician
Practicing since : 2009
Answered : 594 Questions
Hello Doctor,
I noticed a change of color on my inner foreskin. The color is white and the texture is also harder than the normal part of my foreskin. Some of them turn into dark color (darker than my normal skin). There is no pus or inflammation. I don't think it is an STD since I am very careful in choosing partners and using protection during intercourse. What do you think this may be? I did a little bit of research, and I am suspecting it has to do with Balanitis Xerotica Obliterans(Lichen Sclerosus) or it might be lichen planus. But don't let my suggestion affect your diagnosis :)
Thank you.
Posted Sun, 3 Jun 2012 in Penis Problems
Answered by Dr. Yogesh D 1 hour later

Thank you for posting your query.

I understand your concern.

You have provided with very good description of your condition, but in order to suggest better, I would need a few more details regarding the said lesions, hence do write back with the answers.

1. Since how long have you noticed these changes in color and texture?
2. Are the lesions round in shape?
3. Is there any scaling on these lesions?
4. Are these lesions more like a wide patch?
5. Do these lesions itch?
6. Is there any type of discharge from these lesions?
7. Do you have any burning or pain while passing urine?
8. Are these lesions painful?
9. Are these lesions elevated or look like a pimple or just like a flat patch?

It would be great if you could upload a close-up photograph of these lesions in normal light. Please utilize the option provided on the right hand side of your dashboard to attach the images.

Based on your current description, it is quite difficult to come to any conclusion, my best guess would be,

1. Fungal infection,
2. Lichen Sclerosis/Lichen planus,
3. Condyloma accuminata,
4. Molluscum contagiosum.

It would be advisable to get this examined by a dermatologist for a proper diagnosis and treatment.

Hope this was of some help to you. Please do write back with the answers.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Skin discoloration on the penile foreskin. No pus formation. Is this Balantis or Lichen sclerosis? 30 minutes later

To answer your questions:

1. More than 3 months
2. No
3. Not sure, the skin is hardened
4. Yes, for now the area is 1 cm square.
5. Not usually, only sometimes
6. No
7. No
8. No
9. More like a patch.

Fungal infection was also my previous assumption, I've tried Povidone Iodine 10% antiseptic solution and Ketoconazole 2% antifungal cream. I used Ketoconazole for more than a week but less than 2 weeks but I stopped since I didn't notice any change. Thank you.

Answered by Dr. Yogesh D 4 hours later

Thank you very much for writing back with the answers.

It would help me greatly if you could provide a close-up photograph of the lesion.

Based on your description, I can think of the following possibilities,

1. Balanitis Circumscripta Plasmacellularis - (plasma cell balanitis) is an idiopathic, rare, benign penile dermatosis.

2. Mucosal Candidiasis.

3. Erythroplasia of Queyrat (Bowen Disease of the Glans Penis) -- A precancerous state/carcinoma in situ.

4. Lichen Planus.

5. Balanitis xerotica obliterance (BXO).

6. Plaque psoriasis.

7. Reactive arthritis.

8. Vitiligo.

The best way forward is to consult a dermatologist and get skin biopsy done to find out the exact nature of the lesion.

My opinion is, it could be BXO in its initial stages.

Treatment will be as per the exact diagnosis.

Hope this information is of some help to you. Please feel free to write back if you have additional concerns.

Wishing you good health.

Best regards.

Dr. Yogesh. D
Above answer was peer-reviewed by
Follow-up: Skin discoloration on the penile foreskin. No pus formation. Is this Balantis or Lichen sclerosis? 8 hours later
Thank you very much Dr. XXXXXXX I think I would follow your recommendation to consult a dermatologist for diagnosis.


Answered by Dr. Yogesh D 6 hours later
Hello again Mr. XXXXXXX

Thank you for writing back.

Once you get the condition diagnosed, you should also consult a urologist for the appropriate treatment.

I am glad that I could be of some service to you.

Wishing you good health.

Above answer was peer-reviewed by
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