A 40-year-old uncircumcised black man complained of a white rash he has had on his penis for several years.During that time, he noticed increased pain with sexual activity and occasional pain when he urinated. Tests for sexually transmitted diseases (STDs), including syphilis, chlamydia, gonorrhea, and HIV, were negative. A topical antifungal agent and dicloxacillin 500 mg four times daily for two weeks had no effect. Examination revealed a white sclerotic plaque without scale on his prepuce and glans penis.
The patient was a 25-year-old Hispanic man who complained of plaques and papules on his glans penis for several months. The lesions did not itch, burn, or hurt. The man reported that he was heterosexual and sexually active with several women. Tests done at a sexually transmitted disease (STD) clinic for syphilis, chlamydia, gonorrhea, and HIV were negative. A trial of OTC terbinafine cream had proven unsuccessful. He did not have pain with sexual activity, but his partners found the plaques disconcerting.