Causes and Concerns of Prepuce Skin Lesions: What You Need to Know

Causes of foreskin tearing?

Hello, doctor.
A few weeks ago, I experienced a tear in my foreskin (I have phimosis, and the sensation of the torn foreskin felt similar to having a sore in my mouth, both in sensation and size).
However, it healed on its own after about four to five days.
After approximately two to three weeks, I noticed that the original torn area is starting to feel like it might tear again; it’s a little red with about three small spots.
I would like to ask: 1.
Does this resemble a symptom of primary syphilis? 2.
Or could it possibly be balanitis, even though I don’t have any other symptoms like swelling or red spots? Thank you for your time, doctor.

Aguang, 30~39 year old female. Ask Date: 2016/08/30

Dr. Sun Hongshun reply Urology

Hello, the likelihood of balanitis is higher.
As for whether you have contracted syphilis or other sexually transmitted infections, it depends on whether you have engaged in high-risk behaviors.
It is advisable to seek an evaluation at a urology clinic early on, and I would like to remind you again of the importance of safe sexual practices.

Reply Date: 2016/08/30

More Info

When it comes to skin lesions on the prepuce (foreskin), there are several potential causes and concerns that one should be aware of. Based on your description, it sounds like you experienced a skin breakdown that healed but has now returned with some redness and a sensation of impending breakdown. Here are some insights into your questions:
1. Could this be a symptom of primary syphilis?
Primary syphilis typically presents as a painless sore known as a chancre, which usually appears at the site of infection. These sores are usually firm, round, and painless, and they do not typically resemble the symptoms you described. If you are concerned about syphilis or any sexually transmitted infection (STI), it is crucial to get tested. Early detection and treatment are essential for managing STIs effectively.

2. Could this be a case of balanitis (inflammation of the glans) or posthitis (inflammation of the foreskin)?
Balanitis and posthitis can occur due to various factors, including poor hygiene, irritants, infections (bacterial or fungal), or skin conditions like eczema or psoriasis. Symptoms may include redness, swelling, itching, or pain, but you mentioned not having significant redness or swelling. However, the sensation of impending breakdown could indicate irritation or a mild inflammatory response. Maintaining proper hygiene and avoiding irritants is essential in managing these conditions.

Additional Considerations:
- Skin Care and Hygiene: Proper hygiene is crucial in preventing and managing skin lesions in the genital area. Gently clean the area with mild soap and water, and ensure it is thoroughly dried afterward. Avoid using harsh soaps or products that may irritate the skin.

- Moisturization: If the skin is dry or irritated, applying a gentle, fragrance-free moisturizer may help alleviate symptoms. This can help maintain the skin's barrier function and reduce the likelihood of further breakdown.

- Avoiding Irritants: Be mindful of any products that may come into contact with the area, such as soaps, lotions, or laundry detergents. Switching to hypoallergenic products may reduce irritation.

- Observation: Monitor the area for any changes. If the redness persists, worsens, or if you develop additional symptoms such as pain, discharge, or fever, it is essential to seek medical attention. A healthcare provider can perform a physical examination and may recommend tests to determine the underlying cause.

- Consultation with a Specialist: If the issue continues or if you have concerns about STIs, it may be beneficial to consult a dermatologist or a urologist. They can provide a more thorough evaluation and appropriate treatment options based on your specific condition.

In summary, while your symptoms do not strongly suggest primary syphilis, it is essential to rule out any STIs through testing. Conditions like balanitis or posthitis are more likely, especially if there is irritation or inflammation. Maintaining good hygiene, avoiding irritants, and consulting with a healthcare professional if symptoms persist are key steps in managing your skin health.

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