Could the lumps & bumps on my penis be a STD?

Q: I have consulted several doctors about a skin problem on my penis. The doctors say it is not a sexually transmitted disease, but I am worried that it is.

A. The dermatologic conditions that affect the genitalia are very diverse. We often think of genital conditions as those related to sexually transmitted infections. Yet the range of normal variants and non-malignant conditions outweigh disease.

Lesions, bumps or lumps may have a very typical or so-called classic appearance elsewhere on the body and yet look very different on the vulva, perineum and anal area. This can lead to a delay in diagnosis, which may cause anxiety.

There has been an overemphasis and fear-driven messaging around genital health and not nearly enough on non-pathologic lesions.

Some lumps and bumps may not cause any problems and not require treatment as such, and thus some treatment options may be useful for cosmetic purposes only.

Sexually transmitted infections such as herpes and syphilis and other inflammatory conditions, such as psoriasis, require prompt diagnosis and treatment and, where necessary, a specialist for dermatology biopsy and management.

It is important to advise clients to have screening tests for STIs and to complete the course of antibiotics, and provide information on safer sex tools.

• Dr Tlaleng Mofokeng (MBChB), sexual and reproductive health practice, Disa Clinic, safersex.co.za. Mofokeng has recently been named SA's Commissioner of Gender Equality by President Cyril Ramaphosa.

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