[48M] With sudden dark brown streak on penis and chronic medical conditions

Patient Description

A 48-year-old male reports the sudden appearance of a dark brown streak down the shaft of his penis, approximately 3 inches long and 1/2 inch wide, which appeared one day ago. The patient denies any pain, discomfort, itching, or irritation in the area. He has not had any new sexual partners, unprotected sexual activity, recent injuries, or changes in hygiene products or practices. Additionally, the patient has a brown spot on his face that has been present for about two years and has grown larger over time, without any associated itching or irritation. His medical history includes traumatic brain injury, shattered tailbone, bulging disks, chronic back pain, chronic neck pain, eczema (diagnosed in infancy), hernia, corroded arteries, nearsightedness, insomnia, anxiety, and depression. The patient was involved in a car crash in 1995, which resulted in back damage and a traumatic brain injury. He is currently taking Vicodin (six times per day), Seroquel (once per day), Clonazepam (once per day), and Ambien (five times per month). He has no known drug allergies except for penicillin.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for the sudden dark brown streak on the shaft of your penis:

  • Bruising or Hematoma: This could be due to minor trauma or injury that you might not have noticed. Bruises can appear as dark streaks or spots and may not always be painful.

    • Treatment: Typically, bruises heal on their own. Applying a cold compress can help reduce any swelling.
  • Hyperpigmentation: This is a condition where patches of skin become darker than the surrounding skin. It can occur suddenly and may be due to various factors, including friction, hormonal changes, or certain medications.

    • Treatment: Hyperpigmentation often doesn't require treatment, but if it persists, a dermatologist can offer topical treatments to lighten the area.
  • Melanoma or Other Skin Cancer: Although less likely, any new, unexplained skin changes should be evaluated by a healthcare professional to rule out skin cancer.

    • Treatment: Early detection and treatment are crucial. A biopsy may be performed to determine if the streak is cancerous.

Regarding the brown spot on your face that has grown over two years, it could be:

  • Lentigo: These are benign pigmented spots that can appear due to sun exposure and aging.

    • Treatment: Usually, no treatment is needed, but options like laser therapy or topical treatments are available if desired.
  • Melanoma: Any growing or changing spot on the skin should be evaluated to rule out skin cancer.

    • Treatment: A dermatologist may perform a biopsy to determine if the spot is cancerous.

What you can do

  1. Monitor the Streak and Spot: Keep an eye on any changes in size, shape, or color. Take pictures to document any changes over time.
  2. Avoid Trauma: Be gentle with the affected area to avoid further irritation or injury.
  3. Consult a Healthcare Professional: It's important to see a doctor or dermatologist for a thorough evaluation. They can provide a formal diagnosis and recommend appropriate tests or treatments.
  4. Use MDandMe: You can use the MDandMe app to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

Seek medical attention more urgently if you notice:

  • Rapid changes in the size, shape, or color of the streak or spot
  • The appearance of new symptoms such as pain, itching, or bleeding
  • Any signs of infection, such as redness, warmth, or pus
  • Any other concerning symptoms that develop

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and treatment plan.

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5 mo ago

People Also Ask


What could cause a sudden dark brown streak on the skin without any pain or injury?

A sudden dark brown streak on the skin could be due to bruising or hematoma from unnoticed minor trauma, hyperpigmentation from friction or hormonal changes, or less commonly, a sign of skin cancer like melanoma. It's important to monitor the streak and consult a healthcare professional for an accurate diagnosis.


How can I differentiate between a benign skin spot and a potential melanoma?

To differentiate between a benign skin spot and melanoma, look for changes in size, shape, color, or texture. Melanomas often have irregular borders, multiple colors, and can change over time. A dermatologist can perform a biopsy to confirm if a spot is cancerous.


What are the common treatments for hyperpigmentation on the skin?

Common treatments for hyperpigmentation include topical creams containing ingredients like hydroquinone, retinoids, or vitamin C, which can help lighten the skin. In some cases, laser therapy or chemical peels may be recommended by a dermatologist.


When should I seek medical attention for changes in skin appearance?

You should seek medical attention if you notice rapid changes in the size, shape, or color of a skin spot or streak, the appearance of new symptoms like pain, itching, or bleeding, or any signs of infection such as redness, warmth, or pus. It's always best to consult a healthcare professional for any concerning skin changes.


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