OpenHealth Q&A

Lump Under Penile Skin Causing Discomfort When Pressured

A 23-year-old male, 6 feet tall and weighing 150 pounds, who is diagnosed with psoriasis and not currently on any medications, presents with concerns about a hard lump beneath the skin of his penis that tends to sting, particularly when pressure is applied. Approximately six weeks ago, he underwent a punch biopsy of 4 mm on the shaft of his penis, close to the location of the lump. The sutures from the biopsy remained for around six or seven days before being removed, and the area has healed considerably well since then. For the past two weeks, he has been using silicone sheets to manage any scarring. The biopsy was conducted due to an episode of stinging pain, which was initially thought to result from contact dermatitis linked to a bug bite. Prior to the biopsy, he was treated with a 2.5% hydrocortisone cream for four weeks, as per his dermatologist’s instructions. Despite this treatment, he continued to experience the stinging sensation. In hindsight, he believes he might have benefited from postponing the biopsy for a week or two, speculating that the lingering stinging and redness could have been side effects of hydrocortisone usage rather than a separate issue requiring intervention. The small bump being examined was not painful to the touch but could be detected when pressed on. Following the biopsy, results indicated that everything was normal, which left him puzzled as to the origin of the stinging sensation, and he continues to notice hyperpigmentation in the affected area. About three weeks ago, he discovered a hardened lump adjacent to the biopsy scar. He resumed using the silicone sheets, suspecting it might be a keloid scar. This new lump resembles his existing skin tone but is slightly elevated and causes occasional stinging throughout the day. It appears larger and is more noticeable than the initial bump he felt prior to the biopsy. The lump does not drain or show characteristics of a pimple; rather, it feels like a firm mass, and applying pressure exacerbates the stinging sensation. In its flaccid state, it seems to be a harder lump; however, when erect, it feels softer and is less apparent. He is questioning whether this could be a keloid, scar tissue that may dissolve over time, a seroma, a cyst, or possibly related to a sexually transmitted infection (STI). He requests guidance on whether to consult the same dermatologist, seek a different dermatologist, or consider another type of medical professional for this issue. He is also curious about the likelihood of the condition resolving independently without the need for further treatment. Any insights or recommendations would be greatly appreciated as he feels uncertain about the next steps to take.

Answers (1)

7/7/2025, 1:10:40 AM

OpenHealth AI

It's understandable to feel concerned about the hard lump under your penile skin and the associated discomfort. While it’s reassuring that your biopsy results were normal, it’s essential to evaluate the new lump and symptoms carefully. Let’s explore possible causes and the next steps you can take.

Concise Summary:

You have a hard lump that causes discomfort, especially with pressure, following a recent biopsy. Possible causes could include keloid scar tissue, cysts, or other benign conditions. Here’s how you can proceed based on your current situation.

Explanation:

1. Possible Causes:

   • Keloid or Hypertrophic Scar: Given your recent biopsy, this is a possibility, especially since you observe some hyperpigmentation and a firm lump that is elevated.
   • Cyst: Epidermoid cysts can develop in the area and appear as firm lumps beneath the skin; they can also cause discomfort.
   • Other Benign Lesions: There are non-STI related growths that may form as the skin heals.
   • STI Considerations: While less likely due to the biopsy results, any new developments that cause concern should be evaluated.

2. Self-Care Considerations:

   • Continue using silicone sheets as they may help manage scarring.
   • Avoid applying pressure or irritation to the area to minimize discomfort.
   • Monitor the lump for any changes in size, color, or symptoms like drainage or fever, which could suggest infection.

Actionable Next Steps:

1. Consult a Dermatologist: Since you’ve seen good results with your dermatologist, consider returning to them first to discuss the new lump and any ongoing symptoms. It’s crucial to get a professional assessment given the area involved.

2. Documentation: Keep a diary of your symptoms—note any changes in size, sensations of pain, stinging, or new symptoms. This documentation will be helpful for your dermatologist.

3. Follow-up: Be proactive in scheduling a follow-up visit. If you feel unsatisfied with the answers or care from your current dermatologist, consider getting a second opinion from a different dermatologist.

4. Avoid Self-Diagnosing: While it's understandable to speculate on the nature of the lump, professional evaluation is important for appropriate management.

5. Reassurance: Many minor skin lumps resolve on their own, but it’s essential to rule out any issues, especially in sensitive areas. Regular follow-up with your healthcare provider will give you peace of mind.

If you have any further questions or concerns, feel free to ask. Your proactive approach to your health is commendable!