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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3929
Experience:  30 years practice in general and cosmetic dermatology
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White patches on my penis shaft, they were a couple which spread

Resolved Question:

White patches on my penis shaft, they were a couple which spread and they are around my shaft, which treatment do i need to take or which doctor to consult. How much time does it take to get this cured i mean only the white patches.
Submitted: 2 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 2 years ago.

dermdoc19 :

These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.

dermdoc19 :

Good eveilng

dermdoc19 :

Would it be possible to forward a photograph?

Customer:

Good evening, i dont have a photograph with me right now

dermdoc19 :

Is there any scale involved?

dermdoc19 :

Or just white patches? Do you have any white patches any place else?

Customer:

no dont on any other place

Customer:

i dont thing scales are involved

dermdoc19 :

They are flat then. Just areas without p;igmentation.

Customer:

yeah mostly flat

Customer:

but its around the shaft

dermdoc19 :

May I ask your ethinic background?

Customer:

Asian

dermdoc19 :

OK. One thing to consider is vitiligo. This is an area in which vitiligo can frequently start. If there is no scale and the areas are just losing pigment there is a fairly good chance this is what is happening. I would recommend a dermatologist since this is a skin disease and not a urologic problem.

Customer:

does it takes longer time to cure?

Customer:

and one more thing, some times it itches

dermdoc19 :

When treated early, this is a fairly easy condition to treat. It usually responds to a steroid cream,Protopic which is what we call a calcineurin inhibitor.

dermdoc19 :

It often takes a few months. Resistant cases can be treated with the Eximer laser.

dermdoc19 :

Occasionally, vitiligo can itch slightly but if there is severe itching it is probably something else.

dermdoc19 :

Iron and folate will help the pigment come back too.

Customer:

what is folate?

dermdoc19 :

The best OTC prodcut would be Maximum Strength Cortaid Ointment. You can use this twice a day before seeing the doctor.

dermdoc19 :

Folate is the same as folic acid, one of the B vitamins.

Customer:

ok

dermdoc19 :

It is often combined with iron. and can be found in the vitamin section of any pharmacy.

Customer:

i have an appointment with the doctor day after

Customer:

with the dermatologist

Customer:

let me try and send you a photograph of it now

Customer:

so that you will have an idea

dermdoc19 :

Go ahead.

Customer:

im back

Customer:

do you want me send those from here

dermdoc19 :

You click on the paper clip icon to upload.

Customer:

Full Size Image

dermdoc19 :

I am glad you send the photograph. This does not look like Vitiligo, so scratch the advice I gave earlier.

Customer:

Full Size Image

Customer:

check even these

dermdoc19 :

This looks like a rather rare condition: the annular variant of lichen planus. You also have pearly penile papules in the sulcal area, the grove between the shaft and the head of the penis.

dermdoc19 :

This would also explain the itching.

Customer:

yeah im not worried about the Pearly Penile Papules those are common cause i have them from long time

Customer:

Full Size Image

dermdoc19 :

Yeah...I thought that would be a secondary thing.

Customer:

im maily worried about the other white patches which spread and as you can see those became black on head of the penis

dermdoc19 :

No oral sores or nail changes?

Customer:

what?

dermdoc19 :

Sores in your mouth or nail abnormalities.

Customer:

no no

Customer:

Full Size Image

Customer:

here you can see the black spots too

dermdoc19 :

I am also considering Balniltis Xerotica Obliterans which is a form of lichen sclerosus involving the penis.

Customer:

is it harmful

dermdoc19 :

I thought this first, but cases I have seen only had a few bands....

dermdoc19 :

Not harmful but difficult to deal ;with.

Customer:

it has been more than a month or two since these appeared

Customer:

first i thought they are fine might have caused due to some rashes

Customer:

but they never disappeared

Customer:

so i was worried now

dermdoc19 :

I am attending a dermatology meeting tonight and would be happy to show your pictures to a few of my astute colleagues to get there opinion. I do tell you this: it id not an easy diagnosis. You should definitely see a dermatologist, it will be beyond the ken of familly physician. I feel it is one of the two. The more I think of it I think it is more consistent with BXO.

dermdoc19 :

Their opinoion

Customer:

ok

Customer:

will you let me know about their apinion

Customer:

opinion*

dermdoc19 :

Definitely.

Customer:

thank you

dermdoc19 :

Welcome

Customer:

hello

dermdoc19 :

I did attend the dermatology meeting tonight and showed the pictures to three dermatologists. The concurring opinion was that this was lichen planus. We would recommend a potent steroid for three weeks and if not improved a skin biopsy.

Customer:

ok thank you

Customer:

and one more thing; i have an appointment tomorrow with a dermatologist

dermdoc19 :

Let him/her come to their own conclusion. Then you can suggest lichen planus if it differs. You did get four opinions tonight.

Customer:

ok

Customer:

thanks i really appreciate it

dermdoc19 :

You're welcome. I waited until the dinner was over for obvious reasons.

Customer:

potent steriod in the sense

dermdoc19 :

Two weeks with a something like Betamethasone Dipropionate.

Customer:

is it an ointment or

dermdoc19 :

Ointment would be better.

Customer:

how many times a day do i need to apply

dermdoc19 :

Twice.

Customer:

ok

Customer:

do i need a prescription to buy from pharmacy?

dermdoc19 :

For what you have, I strongly doubt anything OTC will budge it.

Customer:

i didnt get you

Customer:

im sorry

dermdoc19 :

The strongest Over the counter medicatoin would be Maximjum Strength Cortaid ointment. I do not feel it is strong enough for lichen planus. In my experience it requires a prescription strength steroid ointment .

Customer:

oh ok

Customer:

any how will be going to the dermatologist

Customer:

hopefully that helps, and cures real fast

Customer:

thanks for the information and your time

dermdoc19 :

You are welcome. Let me know what happens.

dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3929
Experience: 30 years practice in general and cosmetic dermatology
dermdoc19 and other Dermatology Specialists are ready to help you
Expert:  dermdoc19 replied 2 years ago.
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