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What could a serrated lesion mean?

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Practicing since : 2002
Answered : 2565 Questions
I am a 37 year old male, 5'8", 178 pounds. Six weeks ago I noticed a light colored, oval shaped depression (shallow erosion? skin seems thin, but is in tact, no ulceration or bleeding) that is approximately a centimeter wide (maybe a little less) on the shaft of my penis adjacent to the glans on the right. Off center there is a small circle that is reddish (not bright, probably the same color as the glans, slightly purple). It does not hurt or itch. It hasn't changed much in 6 weeks. All of my concern has lead to frequent observation and I think I have convinced myself that another one is developing beside the first, but I'm not sure. Two days ago I noticed that the left side of my penile shaft turned very pink in a triangular shaped area distal to the scar from circumcision (infancy). Both issues are top side. Again, no pain, itching or sensitivity. Free county clinic STD tests negative. What could this be?
Posted Tue, 24 Apr 2012 in Sexually Transmitted Diseases
Answered by Dr. Robert Galamaga 23 minutes later
Thank you for submitting your question.

Your question is a good one and I will do my best to provide you with good information and recommendations regarding your concern.

Of course the first concern which comes to mind with what you have reported would be a sexually transmitted infection. Your symptoms are suspicious but you have reported that testing has been negative so far. I want to make sure that adequate testing has been performed so could you please confirm that testing for syphilis has been completed. This would be my one concern with a all serrated lesion such as that which you report.

Another possibility which we must consider would be a fungal infection. Fungal infections can cause a gradually worsening degree of redness and or also ration of the shaft of the penis.

I would like to recommend that you will go to your local pharmacy and purchase a topical cream. The cream is cool time is all. This is generally contained in several generic preparations and if you are unable to find it I am sure the pharmacist will give you good assistance. I recommend that you apply this cream twice a day for 10 days to the affected areas.

We should expect to see some improvement within a few days. If you do not see any significant improvement I think you should have a repeat sexually transmitted disease screen. If that is again negative I think you will need to see a dermatologist for a focused examination and consultation.

Thank you again for submitting your question. I hope might answer has served to be both helpful and informative. If you have any additional concerns I would be happy to address them.


Dr. Robert.
Above answer was peer-reviewed by
Follow-up: What could a serrated lesion mean? 4 hours later
Thank you for your response. Syphilis testing has been completed. That was the only thing I could find on-line that even closely resembles what I am looking at, but again, there is no ulceration just a depression in the skin and the light discoloration. I am uncertain as to what type of cream I should look for specifically. Thanks.
Answered by Dr. Robert Galamaga 3 hours later
Hello and thank you for the follow up question.

The topical cream which you should be looking for is clotrimazole. This is the active ingredient in many generic over-the-counter antifungal creams. This should be readily available at your local pharmacy. If you are having any problems finding this with the assistance of the pharmacist please let me know.

Thank you again for your follow-up question. I hope you found my answer and response to be helpful and informative. If you have any more concerns I am here for you.


Dr. Robert
Above answer was peer-reviewed by
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