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Post phimosis surgery, BXO, hyperpigmented macules on penis, taken steroid. Malignancy chances?

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Im a 30 year old south asian male, STD free, with previously diagnosed phimosis (treated with circumcision 2 years ago) and BXO (treated with steroids). No other medical issues and no other derm diagnoses. Over the past 1 year (one year post circumcision and steroids) i have developed 4 hyperpigmented macules on the glans (glands) penis. one of the four are located inferior to the meatus (where the BXO was previously) and extends upwards to surround the meatus. They are completely asymptomatic. I was given a course of steroids x 4 months which hasnt really made a difference. Ive discontinued this now. Any ideas? BXO is a premalignant disease, is it not? Im trying to get in to see a dermatologist but have recently moved cities and trying to find a GP to make the referral. Extremely worried this is a malignant transformation.
Posted Thu, 19 Apr 2012 in Men's Health
Answered by Dr. Bharat Chawda 15 hours later
Dear ,

You have been treated in the right direction regarding BXO and phimosis till now.

The initial treatment is topical steroid and if not responding then circumcision is rightly done.
As far as malignancy is concerned, there is a very slight possibility of BXO turning malignant. BXO is regarded as a self limiting condition. Yes it is good to rule this out with a local biopsy of the lesion under the meatus.

The most common malignancy seen in such cases is squamous cell carcinoma, which appears as a small erythematous raised lesion. The early detection is always good for easy treatment.

Other common complication could be narrowing of urinary meatus. It can also be just a benign junctional mole (asymptomatic flat dark black mole).

It is commendable that you have realized the importance of following up with such lesion and you wanted to do something about it. It is important to get an initial local examination by your GP and get an appropriate referral to either a dermatologist or a urologist.

Hope I've answered your query and that you recover soon.

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Dr.Bharat chawda
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