Red Bumps on the Penis: Could It Be Syphilis?

Is it a virus?

Hello doctor, I would like to ask about a red area in the coronal sulcus of my penis.
It's not a spot or a patch, but rather small red areas that seem to be centered like little bumps, with slight redness around them.
I saw a doctor yesterday, and he mentioned that there was some bleeding and prescribed me with a topical ointment (雷公草 and 康美藥膏) and also gave me oral medication.

I want to mention that about five months ago, I had a similar small bump that looked like a pimple, and when I consulted a doctor then, he said it was simply herpes.
Blood tests at that time were normal.
Now, five months later, I'm experiencing similar symptoms again, and I had blood drawn yesterday; I will wait for the results next week.

I am concerned if this could possibly be syphilis.
During the first occurrence, I had a steady partner, and since then, I have engaged in sexual activity with a condom.
I have not had any sexual activity since then, and I'm worried about the possibility of syphilis.
I'm feeling quite anxious about this situation.
Could you please help clarify this for me? (The doctor I saw didn't provide much information, only suggesting that if it’s not syphilis, it might be due to phimosis and that a circumcision could resolve it.)

Xiao Ha, 20~29 year old female. Ask Date: 2016/01/28

Dr. Xu Weikai reply Urology

Hello, it's difficult to determine.
Syphilis requires a blood test for diagnosis, and it is challenging to assess based solely on clinical symptoms.
I recommend getting a blood test.
If you have any further questions or need clarification, feel free to ask, and we can discuss it further.
Information from the internet should only be used as a reference; if necessary, you should seek medical attention at a healthcare facility.
This message is from Dr.
Hsu Wei-Kai, Director of the Urology Department at Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2016/01/28

More Info

When it comes to concerns about red bumps on the penis, particularly in the coronal sulcus area, it is essential to approach the situation with caution and a thorough understanding of potential causes. Based on your description, it seems you are experiencing small, red, bump-like lesions that have been present for some time, with a history of similar symptoms. You mentioned that a doctor previously diagnosed you with herpes, and you are now worried about the possibility of syphilis.

Firstly, it is important to note that syphilis can present in various ways, including as sores or lesions on the genital area. However, the appearance of syphilis lesions typically differs from what you have described. Primary syphilis often presents as a single, painless sore known as a chancre, which is firm, round, and usually appears at the site of infection. Secondary syphilis can cause rashes and lesions that may appear on various parts of the body, including the genital area, but these are usually more widespread and not localized to small bumps.

Given your history of herpes, it is possible that the red bumps you are experiencing could be related to a recurrence of the herpes virus, especially if they are similar to what you experienced previously. Herpes lesions can appear as small, painful blisters that eventually crust over. If your bumps are not painful and do not resemble blisters, they could be something else entirely, such as irritation from friction, an allergic reaction, or even a benign condition like pearly penile papules, which are common and harmless.

The fact that you have been tested for sexually transmitted infections (STIs) and that your previous tests came back normal is reassuring. However, it is crucial to follow up on your recent blood tests to rule out any new infections, including syphilis. If there is any doubt, a more comprehensive STI screening, including specific tests for syphilis (such as RPR or VDRL tests), may be warranted.

In terms of treatment, your doctor has prescribed topical medications and oral medication, which suggests they are addressing an infection or inflammation. If the symptoms persist or worsen, it is essential to return to your healthcare provider for further evaluation. They may consider a referral to a dermatologist or a specialist in sexual health for a more detailed examination.

In conclusion, while the possibility of syphilis cannot be entirely ruled out without proper testing, it is essential to consider the broader context of your symptoms and medical history. Continue to monitor your symptoms, adhere to your doctor's recommendations, and ensure you follow up on your blood test results. Open communication with your healthcare provider is key to addressing your concerns and ensuring appropriate care.

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