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Urology/Red bumps along penis frenulum

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Hello Dr.Goldstein,

One month ago I went to STD clinic due to burning sensation while urinating and was tested positive for chlamydia and was given 4x250mg Azithromycin pills. I also noticed 4 small red bumps along the frenulum and never saw them before. The STD Clinic NP told me she had seen them before and didn't think it was anything to be alarmed about. Now, there is no pain or anything, but it doesn't look natural or healthy, and I'm pretty I never had them before (or at least I don't think they stood out as much)

What do you think could it be - or have you seen this before?

Thank you so much in advance for taking your precious time!

Answer
James, it is difficult to make this type of diagnosis over the internet without the ability to do a physical examination.  I do not believe your skin lesions are related to any STD.  Common causes would be a bacterial, yeast or fungal infection, contact dermatitis, or a primary dermatologic condition (such a psoriasis, eczema, lichen planus, lichen sclerosis,  etc.).  Infections involving the penile glans occur almost exclusively in uncircumcised men (which you obviously are not) & are more common in diabetics.   They respond to proper genital hygiene and topical antibacterial creams.  If refractory, circumcison is sometimes necessary for cure.  Yeast and fungal infection usually respond to a 10 day course of medication such as lotrimin, lamasil or nystatin cream.  Contact dermatoses are much more difficult to track down as it usually infers that you penis is touching something it is allergic to.  This can be a substance on your hands such as chemicals used at work, soaps, detergents used for under clothes, condoms, feminine hygiene sprays your partner might use, etc.  The treatment is eliminating the cause and using at least 1% hydrocortisone or another steroid cream as needed.   If your problem is refractory, consultation with a urologist or dermatologist is suggested.  Good luck.

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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