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Dermatology/Shiny Red Spot with tiny white pinpoint center on Penis

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Hi, serial monogomous 52 yr old male, 32 years with same woman with second occurrence (first one 2-3 years ago, disappeared after 2 months with no treatment) of a shiny, red, singular spot just off rim of penis head.  No other spots anywhere else.  Second occurrence is approximately twice the size of the first occurrence 2 years ago. Standard non-prescription creams and antifungals do nothing.  Have had approximately 3 weeks this time, enlarging slightly from week-to-week.  No pain, no itching, no discharge, just a very slight flaking every 3-4 days in center of redness, apparently from a very, very slight white pinpoint pustule -- that point is probably smaller than the head of a pin . . . almost invisible.  Most seems to resemble balanitis in pics I've seen, but not sure.  Pics attached.  Thanks for any help in diagnosis and treatment recommendations!

Answer
You have a condition called balanitis.
Balanitis is swelling of the foreskin and head of the penis.

Causes
Balanitis is most often caused by poor hygiene. Other possible causes include:

Diseases such as reactive arthritis and lichen sclerosis et atrophicus
Infection
Harsh soaps
Not rinsing soap off properly while bathing
Uncontrolled diabetes
Other irritants

Symptoms

Redness of foreskin or penis
Other rashes on the head of the penis
Foul-smelling discharge
Painful penis and foreskin
Exams and Tests
Your health care provider may be diagnosed the problem with only an exam. However, you may need skin tests for viruses, fungi, or bacteria. A skin biopsy may also be needed.

Treatment
Treatment depends on the cause of the balanitis.

Antibiotic pills or creams are used to treat when balanitis that is caused by bacteria.
Steroid creams may help balanitis that occurs with skin diseases.

Anti-fungal creams will be prescribed if it is due to a fungus.

In your case you look like you have an infection so in your case oral antibiotics would be helpful.  

Dermatology

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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