Common skin disorders and infections can cause cutaneous penile lesions (see table Causes of Cutaneous Penile Lesions).
Causes of Cutaneous Penile Lesions
Category | Cause |
|---|---|
Common skin disorders | Allergic or irritant contact dermatitis Carcinoma in situ: Also known as erythroplasia of Queyrat, Bowen disease Fixed drug eruptions Papulosquamous or systemic disorders |
Sexually transmitted infections* | Genital warts (condylomata acuminata) |
Rare infectious causes | Fungal infections |
* See also Sexually Transmitted Infections: Introduction. | |
Balanitis xerotica obliterans
This lesion, another name for lichen sclerosus et atrophicus in men, is an indurated, blanched area near the tip of the glans surrounding and often constricting the meatus. It results from chronic inflammation and may lead to phimosis, paraphimosis, or urethral stricture
The area around the urethral meatus is indurated and blanched. Scratching and rubbing have resulted in irritation and petechiae.
© Springer Science+Business Media
© Springer Science+Business Media
This photo shows erythroplasia of Queyrat.
© Springer Science+Business Media
This photo shows squamous cell carcinoma in situ of the glans penis with a sharply demarcated, bright red, velvety plaque.
© Springer Science+Business Media
Annular lesion on the glans of the penis is consistent with lichen planus.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
This patient has a ring of pearly lesions along the corona of the glans (from left to lower right) consistent with pearly penile papules. He also has penile warts (center) caused by human papillomavirus (HPV).
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
The area around the urethral meatus is indurated and blanched. Scratching and rubbing have resulted in irritation and petechiae.
© Springer Science+Business Media
© Springer Science+Business Media
This photo shows erythroplasia of Queyrat.
© Springer Science+Business Media
This photo shows squamous cell carcinoma in situ of the glans penis with a sharply demarcated, bright red, velvety plaque.
© Springer Science+Business Media
Annular lesion on the glans of the penis is consistent with lichen planus.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
This patient has a ring of pearly lesions along the corona of the glans (from left to lower right) consistent with pearly penile papules. He also has penile warts (center) caused by human papillomavirus (HPV).
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
Carcinoma in situ
Carcinoma in situ can include
Erythroplasia of Queyrat: Squamous cell carcinoma in situ of the glans or prepuce
Bowen disease of the penis: Squamous cell carcinoma in situ of the penile skin
Bowenoid papulosis: Associated with human papillomavirus (particularly HPV types 16 and 18)
Erythroplasia of Queyrat and Bowen disease of the penis are well-circumscribed areas of reddish, velvety pigmentation in the genital area, usually on the glans or at the corona, primarily in uncircumcised men.
Paget disease of the nipple (not to be confused with Paget disease of bone) is a rare intraepithelial adenocarcinoma that can occur in extramammary locations, including the penis.
Bowenoid papulosis involves smaller, often multiple papules on the shaft of the penis.
These conditions are considered intraepithelial neoplasia or carcinoma in situ and should be biopsied.
Penile lichen planus
This lesion occurs as small plaques, papules or macules, sometimes annular, on the glans or shaft and may be mistaken for pemphigoid or erythema multiforme. Pruritus is common.
Penogingival syndrome in men (and vulvovaginal gingival syndrome in women) is a more severe form of erosive lichen planus. It occurs on both oral and genital mucosa. Ulcers may develop and cause pain.
Lichen planus usually resolves spontaneously. If asymptomatic, it may not require treatment. Topical corticosteroids may help relieve symptoms.
Pearly penile papules
These papules are small, harmless angiofibromas that appear on the corona of the penis as dome-shaped or hairlike projections and tend to be skin-colored. They may also appear on the distal shaft. They are common, occurring in up to 10% of men. They are not associated with human papillomavirus, although they may be mistaken for genital warts. Treatment is not required.
Contact dermatitis of the penis
Contact dermatitis of the penis has become more common with the widespread use of latex condoms. Dermatitis appears as red, pruritic lesions, sometimes with weeping or fissures. Treatment is with topical corticosteroids and use of nonlatex condoms (but not natural condoms, which do not provide adequate protection against HIV). Mild over-the-counter corticosteroids can be tried first, with use of middle- or high-potency prescription preparations as needed.
