There are hundreds of reasons one can develop bumps on penis. Bumps can be painful or painless, red, dark or skin colored, small or large, round or flat-topped, smooth or rough, itchy or non-itchy, hard or soft and the list goes on. It can either be due to non-infectious cause or sexually transmitted, can be harmless or cancerous. Most bumps on penis are harmless, but before you misdiagnose yourself and regret later, it is always wise to see expert medical help. As there are hundreds of cause of bumps on penis, we’ll not go in details about each bump, but we’ll try to include most common bumps in this articles.
Common Causes of Bumps on Penis
1. Fordyce spots
Seen in almost 80-90% of the population, Fordyce spots are small harmless and painless, white or yellowish bumps. They are commonly seen in shaft of penis, glans penis and scrotum. They don’t require any treatment.
2. Pearly penile papules
These harmless bumps appear as small skin-colored or whitish papules in one or several row encircling the base of the head of penis (glans). Commonly seen in uncircumcised penis,they are usually asymptomatic and may persist throughout the life. No treatment is necessary beside its cosmetic appearance.
3. Molluscum contagiosum
Molluscum contagiosum are small painless, smooth skin-colored bumps that are usually sexually transmitted, but can also transmit through auto-inoculation from other parts of the body. Molluscum is harmless and is usually self-limited which gradually resolves over several months.
4. Genital warts
Genital warts are sexually transmitted bumps that are mainly seen on shaft and glans penis and sometime on scrotum and perianal region. Initially they are small, painless, smooth, skin-colored bumps but gradually increase in size and number and appear as irregular, rough surfaced and grouped lesion that sometimes resembles cauliflower.
Scabies in quite common problem and is characterized by intensely itchy lesion on the fingerwebs, abdomen, and genitals. Individual will often have very itchy pimples like bumps or nodules on their penis or scrotum. Topical permethrin 5% lotion applied below the neck all over the body overnight will usually get rid of the problem. Application can be repeated after 5-6 days for better result. In addition oral ivermectin may also be used in adult.
Folliculitis is quite common painful bump on genital region and can occur anywhere but less common on glans penis due to absence of follicles. Excess sweating and heat are the main cause. Topical antibiotics with antibacterial soaps will usually get rid if them; if not improved oral antibiotics may be needed.
7. Bowenoid papulosis
Bowenoid papulosis is an HPV induced sexually transmitted disease and shares clinical similarities with genital warts. BP is somewhat larger and darkly pigmented thank genital warts. HPV type 16 and 18 is thought to be the culprit. Although lesions can be seen anywhere around ano-genital areas, they are commonly seen on the shaft of penis. Bowenoid papulosis is considered to be transitional state between genital warts and Bowen disease and has potential to be malignant.
8. Condylomata lata
Condyloma lata are skin colored to dark colored bumps with rough surface commonly found on moist areas in the genital. These bumps are characteristic of secondary syphilis and are sometimes misdiagnosed as genital warts. Although most lesions are warty bumps, few may ulcerate.
9. Lichen Nitidus
Although relatively uncommon on genital areas, these small tiny skin-colored or red bumps can also appear on penis shaft that might create confusion. These are asymptomatic or sometimes may itch. Lichen nitidus is harmless, therefore, need not be treated.
10. Penile Milia
Milia on penis are not quite common but again these can occur. Milia are tiny skin-colored or white harmless bumps that don’t require any treatment. They can simply be removed with needle by unroofing the lesion and extracting the white content.
11. Skin tags (Acrochordon)
Skin tags are soft, harmless, asymptomatic skin-colored or slightly brownish bumps that can sometime appear on penis. Although they are sommon on axilla, neck and inguinal flods, they sometime do appear on penis shaft creating confusion with genital warts. Repeated friction and rubbing can irritate the lesion and gets inflamed. Otherwise they can be left alone, or can be removed for aesthetic reasons.
Syringoma appear as skin-colored or yellow-white to dark-brownish colored multiple asymptomatic smooth, rounded or dome shapes bumps on the shaft of penis particularly in young individuals below 30 years. They are harmless and can be treated with surgical excision, cryotherapy (liquid nitrogen), electro-cautery, CO2 laser, electrodessication and curettage.
13. Lymphangioma circumscriptum
Lymphangioma circumscriptum is an uncommon skin condition that appears due to localized developmental defect of lymphatic tissue in the dermis. These lesions may be misdiagnosed as genital herpes, Molluscum contagiosum or genital warts, so it is wise to visit the doctor and manage it accordingly.
14. Seborrheic keratosis
Seborrheic keratosis is one of the uncommon non-infectious and harmless diseases of the penis that can be mistaken for genital warts. They can be seen as macules, papules or plaque depending on the stage of development. It can be treated with excision, electro dissection and curettage, cryotherapy (liquid nitrogen) and CO2 laser ablation.
15. Lichen planus
Lichen planus on the penis can occur as a part of lichen planus on other body area. Isolated lichen planus of the penis is rare, erosive variant of lichen planus can occur on mucosal surface of genitals.
16. Scrotal calcinosis
Scrotal calcinosis is an uncommon harmless disorder of the scrotal skin where slowly growing multiple, painless, hard scrotal papules or nodules are seen. They are usually not seen on the penis and usually occur in the presence of normal calcium and phosphate metabolism. Surgical excision is the best way to get rid of them.
17. Epidermoid Cyst
Although epidermoid cysts are very common on other parts of the body, penile epidermoid cyst is not that common. They are usually harmless, single, soft and smooth cysts that can be surgically removed.
18. Median raphe cyst
Median raphe cyst of the penis is an uncommon benign congenital cyst that can be seen anywhere between the tip of the penis and the anus, most commonly near the glans and the shaft of penis. Median raphe cyst arises due to defects in embryological development of the male genitalia.
Angiokeratoma of scrotum are small, smooth, bright red to blue or purple colored vascular tumors commonly seen on scrotum but can also be found on the shaft of penis and the glans penis. Initially they are asymptomatic but can be itchy and bleed after minor trauma. Although harmless, symptomatic lesion can be removed with cryotherapy, electrocoagulation, local excision, laser ablation
20. Genital herpes
Genital herpes is sexually transmitted infection characterized by painful fluid filled bumps (vesicles) or sallow ulcers with red base commonly seen on shaft of penis. Herpes simplex type 1 and 2 (HSV-1 and HSV-2) causes genital herpes, most commonly HSV-2. There is no cure for genital herpes, but can be treated and minimize with oral anti-viral agent like Acyclovir or Famciclovir.
Lymphocele of the penis is a harmless, self-limiting condition that is commonly seen in sexually active males aged 20 to 40 years. It is cord like swelling seen vertically or horizontally on the shaft of penis usually after vigorous sex or masturbation. Usually no treatment is required as it resolves spontaneously in most cases.
There are several causes of bumps on penis all of which cannot be described in one article. Some other causes of bumps on penis but not limited to are as follows:
23.Primary granuloma inguinale
24. Primary lymphogranuloma venereum
25.Insect bite and tick bite
28.Genital smooth muscle hamartoma
In rare cases:
45.Amelanotic malignant melanoma
1. Fitzpatrick’s Dermatology in General Medicine