Sexually Transmitted Diseases/is this something to worry about?


the mark
the mark  
QUESTION: Hi doctor, my name is Singh, age 23 and I live in Calgary, Canada. I have a red dot at the end of my penis and also a mark on the shaft of my penis. I have attached the pictures of these. I went to the local clinic and was told it's nothing to worry about and gave me a cream called Hydroval 0.2% and recommended me to a dermatologist which scared me. Even though he said its nothing to worry about, I still want another expert's advise. Please take a look and reply

ANSWER: Hello Singh,
I cannot see anything on the shaft of your penis due to a dark shadow covering most of it. The red mark on the glans corona (rim) appears to be some dilated blood vessels, a normal variation. Nothing to worry about. The steroid cream they may have given to you way have helped diminish the inflammation. A dermatologist may be helpful, if the cream they gave you does not help.

Good luck!

---------- FOLLOW-UP ----------

little ring
little ring  

different angle
different angle  
QUESTION: Thanks for the reply doctor. Here is an updated image.

Hello Singh,
The new photo clearly shows an irregular circular rash with elevated periphery. This is consistent with a skin infection caused by a fungus. In place of the steroid cream you mentioned previously, I would recommend a skin antifungal such as terbenefine (Lamasil), miconazole (Micatin), or tolnaftate (Tinactin).

Good luck!

Sexually Transmitted Diseases

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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