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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
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Experience:  Medical Doctor Trained at a Top Academic Institution
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I 100%, with my experience with medicine in multiple medical

Customer Question

I 100%, with my experience with medicine in multiple medical fields, have Fordyce's Spots on my lips. Differential Diagnosis was easy with these. My question is this. I had small clear bumps on my shaft of my penis and on the glans. The fill with clearish fluid and can be popped, are painless(until I pop them and then obviously have a open lesion). What are they? I went to the VA and I was diagnosed with HSV-1 but was never given a test, or even had my penis looked at. I ask the Doctor about the lab test and she stated it did not matter because either way the treatment is the same. Now that I have Fordyce's Spot on my lips, I have realized that I do have Fordyce's Spot on my shaft but these are different looking, they are skin colored/pale colored from the clear small bumps on my penis. The Fordyce's Spots I thought were just my hair follicle root have sebaceous fluid clogging it. Anyways That is the Dx for one set of S/S. My Concern is these other bumps. I have looked up information on the bumps now that I have the spot in my mouth, and found Tyson's Glands. Those are dead on what it looks like and the s/s seem the same. Issue is I can not find anything so far on the web that I can use as differential diagnosis between Tyson's versus HPV-1 Genital. I have never had any pain, tingling, itching, etc. with these bumps, aside from the skin irritation from me popping them just like any zit on my face, except the zits on my face always hurt a lot more, these don't too much aside from the rare one. They also never cluster, they are close in proximity sometimes. They usually always pop up in the same exact spot after a varied time span. But the three I just popped 5 days ago where in a new spot on the underside of my shaft and near the base of the glans. Any help would be grateful. Unfortunately, I do not have any pics, but I did pop three bumps 5 days ago and they are completely gone, no redness or any other S/S. And I had only one Acyclovir Left so I took that but I (unlike what the Doctor Prescribed me.) only take them when I have an "outbreak", to avoid the cost of the medication and the possible damage of side effects from long term use. And theoretically one half dose of my medication should have not cleared it up like that. Correct?


 


Also not sure if this is any correlation, I doubt it, but I do occasionally get really itchy clear bumps on my fingers between each individual phalanx.  And a few years ago I had a Unknown Ideology Contact Derm, When to several specialist as this rash was all over and lasted for a greater duration.  I have not had an episode of that since 2008. 

Submitted: 1 year ago.
Category: Medical
Expert:  Camille-Mod replied 1 year ago.

Hello,

I'm Camille, and I’m a moderator for this topic.

We have been working with the professionals to try to help you with your question. Sometimes it may take a bit of time to find the right fit.

I was checking to see if you had already found your answer or if you still needing assistance from one of the professionals.

Please let me know if you wish to continue waiting or if you would like for us to close your question.

Also remember that we have a multitude of categories to help you with all your needs from Health, Pets, Computers, Cars, Finance, Law, to Home Improvement, and more.

Thank you,

Camille

Customer: replied 1 year ago.
No I have not found the information I was requesting. So does this mean at this point I can be refunded the amount I paid since the question has not been answered? I figure at this point I probably can do a lab smear of anything shows up again and see if I can test it to find out 100% versus trying to get information on differential diagnosis between the two. Anyways thank you.
Expert:  Camille-Mod replied 1 year ago.

Hello,

Thank you, XXXXX XXXXX continue to look for a professional to assist you. Since the professionals log in at different times, it is very difficult to predict when one will come on with your particular area of expertise. Please let me know if I can be of any further assistance while you wait.

Best,

Camille

Expert:  Dr. Phil, MD replied 1 year ago.
Thanks can I help on this one?
Customer: replied 1 year ago.
Sure, it has gone from Derm, to urology, and know you are internal med but I feel it is a general medical knowledge question
Expert:  Dr. Phil, MD replied 1 year ago.
Thank you Erik

First of all, it is inappropriate for the VA doctor to diagnose herpes without a culture.

No pain equals no herpes.

Can you send a picture of the lip lesions?

That is what you are mainly worried about correct?
Customer: replied 1 year ago.
No that is not my main concern. I can send a picture of my lip, but
From everything I have read a looked up it is Fordyce's Spots. My real concern is what are the reoccurring bumps that show up on my penis. Unfortunately there is no symptom if those currently.
How do I upload a picture?
Expert:  Dr. Phil, MD replied 1 year ago.
you can upload here or upload to photobucket

These spots sound like pearly penile papules (PPPs) or fordyce spots as well.

Definitely not herpes if not painful
Customer: replied 1 year ago.
I was under the impression that the signs/symptoms for Fordyce Spots was the white/pale bump and not filled with clear/oil like substance. And PPP do not pop and are skin bumps correct?


So therefore that would rule out via differential diagnosis the clearish bumps I get that easily pop and secrete a serous type fluid and the symptoms are no pain, no itching. The signs are stated in the last sentence with the addition of the bump not being clustered, in small diameter (1mm or so) and relatively in close proximity.


Once again I am trying to figure out if they are actually Tyson's Glands or some other sort of dermatitis. Like you said I felt that the VA doctor missed diagnosed me with HSV-1 (genital) because I stated I gave had cold sores, but that has been since I was a kid and are very rare and no labs were taken or no physical examination of my genetial region was done. The Doctors in the VA are constantly overworked and understaffed, so I am seeking outside advise because it will take me another three months to get seen again.

I did research and look up the CDC, among others, but Derm like Interal Med is a special beast with numerous nuances that require a specialty with experience and knowledge of which I do not have.
Expert:  Dr. Phil, MD replied 1 year ago.
That is not true about Fordyce spots.

They can pop and secrete serous fluid

That is generally true about PPPs though

I still think it is likely fordyce spots though
Customer: replied 1 year ago.
Well that is good news. Is there a smear that can be done to confirm if the are Fordyce Spots? I realize there is for herpes but I am unsure about the labs for the Fordyce.And what exactly separates the diagnosis between Fordyce and Tyson's? Is it possible to have cases of both?And can they mimicke anything else? And if there is no symptom of pain, itchiness, irritation or anything of the likeness then that rules out 98% herpes correct, as I realize the only way to rule out 100% would be a lab smear correct?Is there a way to upload photos to you via a none public site say via email to a secured server which still protects my privacy?Thank you Doc for assisting me with all these questions.
Expert:  Dr. Phil, MD replied 1 year ago.
Tysons and fordyce are the same thing

Its not herpes without pain or itching

Yes upload them to photobucket

Here's an article for you

http://fordyce-spot.blogspot.com/2012/05/fordyce-spots-can-also-appear-around.html?m=1
Customer: replied 1 year ago.

Ok, I had to start a photobucket account.


 


Here is the link.


Photo 1


http://i1281.photobucket.com/albums/a519/ErichCA07/image_zpsde0eac1f.jpg


 


Photo 2


http://i1281.photobucket.com/albums/a519/ErichCA07/image_zps1ccabda9.jpg

Expert:  Dr. Phil, MD replied 1 year ago.
Yes, fordyce spots sir.

I'm 100% sure
Customer: replied 1 year ago.

Thank you,

 

One last question is there a lab test that can be done for fordyce spots on my penis? Since the link you presented I have seen those but usually on the head they look like a blister and are still asymptomatic, and do secrete the fluid that is mentioned. I just would like to make 110% sure for my own sanity and I would like to not be taking Acyclovir and fix my Military VA medical record of having the diagnosis of genital herpes.

 

 

 

 

The pics from this gentleman resemble the spots I get.

http://www.justanswer.com/dermatology/6p4xh-tiny-bumps-underside-top-penis-head-around.html

Expert:  Dr. Phil, MD replied 1 year ago.
No there is no test

You just need a good doctor to document they are not herpes

Which they aren't
Dr. Phil, MD, Medical Doctor
Category: Medical
Satisfied Customers: 43403
Experience: Medical Doctor Trained at a Top Academic Institution
Dr. Phil, MD and 4 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

Thank you very much for your help.


 


Have a great week, Doc.

Expert:  Dr. Phil, MD replied 1 year ago.
You too. :)

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