Dr. Deepti Shukla
Venereology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have rashes on the penis under the head. It has been there for a while. It started as a small rash and continues to get worse. It is in the folds of skin under the head of penis and never looked bumpy until now. I am sexually active and still masturbating actively. Previously it was just a whitish spot. Now it started to get soft, moist, and crack open. I hope it is not herpes. Please help.
Hello,
Welcome to icliniq.com.
Such rashes on the penis can occur due to multiple causes including syphilis, herpes, candidal balanitis, and many more. I need to ask you a few questions so I can advise you properly. Since when do you have this rash? Do you have burning associated with it? Do you have itching associated with it? Any discharge from the penis? Any history of unprotected sexual exposure or any unsafe sexual practice? Please get back to me with answers to these questions so I can help you out.
Patient's Query
Thank you doctor,
Yes, history of stupid and unsafe decisions with sex recently. It has been about a month. It started just as a small rash, and light patch. But it is in the folds so very hard to keep dry. Itching and burning only when irritated. If I leave it alone for a few days, it starts to go away and does not itch or burn as much. No discharge. I had a little discharge two weeks ago and did a treatment for STDs and it went away. When left alone, it typically starts to go away, and just look like a rash, so I thought it was nothing, but it is getting worse and I do not know what to put on it or what to do? It is not itchy or painful, nor did it start as pimples or bumps. It started as more of a white looking area. It has gotten bigger.
Hello,
Welcome back to icliniq.com.
From the history and photo (attachment removed to protect patient identity), I gather it is either syphilis or candidal balanitis. It is definitely not herpes. Now the morphology, that is the look of the rash is very similar to syphilitic ulcer. Syphilitic lesions are typically painless rash or erosion. As you also have a history of unsafe sexual exposure so we must rule out syphilis. Candidal balanitis is a mild fungal infection of genitals in which rash itching occurs. I am suggesting you Clotrimazole cream, apply at night daily for three weeks. But get your VDRL (venereal disease research laboratory) test done for syphilis as we need to rule out this. And please always practice safe sex no matter what.
Patient's Query
Thank you doctor,
Is it possible that this cream also help to treat STDs such as syphilis, chlamydia, gonorrhea and trichomonas?
Hi,
Welcome back to icliniq.com.
No, this cream will not treat other STDs (sexually transmitted disease). This is an antifungal cream and will treat balanitis only. For syphilis, you will have to take Penicillin injection or Doxycycline tablet course. Similarly, for gonorrhea, chlamydia and trichomoniasis, treatment for all these are completely different as different antibiotics are given for all three. That is why I am suggesting you to get your VDRL test done for syphilis. Gonorrhea and Chlamydia have different presentation.
Patient's Query
Thank you doctor,
Can I treat for all of these while also getting tested and awaiting test results? I have picked up the cream today.
Hello,
Welcome back to icliniq.com.
No, treatment and antibiotics are different for all these STDs. For syphilis, penicillin injection can be given. For chlamydia, Azithromycin. For gonorrhea, Ceftriaxone injection can be given. And for trichomoniasis, Metronidazole tablets can be taken. So there is no point of taking so many antibiotics. Also, if you take all these medicines your tests results will get affected and reports may come false positive. So, I would advise you please get tests done and then take medicine depending on the reports. And do not take unnecessary tension. We will see what comes in the report and will treat you accordingly.
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