I am a medical tourism advisor looking for advice for a 60-year-old male patient who has severe skin issues with the soft tissue of his glans penis area where some infection has developed in about the last 21 days. He has rashes and multiple red spots on the penis head and visible infection on the glans penis area only. No infection on the soft sliding part of the foreskin or any other aspect of the skin. No pain unless the foreskin is withdrawn or while water touches during the bath. There is no much irritation unless the area is touched or disturbed. Medicines applied are Lobate GM, which does not give much relief, Quadriderm, Canesten, and T- bact Mupirocin. The antibiotic taken ten days back is Augmentin 625 mg twice daily for five days.
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I have no history of fever, but sometimes feel feverish for a short while. I am sexually active with my spouse. I have minor itching and burning when passing urine or when taking a bath. I have pain sometimes while taking a bath and applying medicine, but it is quite manageable. I do not have any tingling sensation. I regularly wash that area and very particular about hygiene, and use only clean cotton underclothes. In the past few months, I used medicines like Lobate or Quadriderm, Xylocaine, or Canesten and T- bact. I use a contraceptive, which is latex, and I am not allergic to it. I use soaps during bath and after intercourse. I am allergic to Sulpha drugs. And I have excess sweating. I do have a minor fungal and bacterial infection while traveling outside. I am not diabetic and have no history of psoriasis, eczema, swelling, or inflammation. I have mild joint pains and had a leg fracture last year.
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It is pseudoepitheliomatous keratotic and micaceous balanitis common in the elderly.
Avoid using scented soap or harsh soap in that area. Use a non-soap mild cleanser like Episoft cleanser to clean the genitals. Pain on urination, irritation, inflammation, and redness are the symptoms of balanitis. Possible irritants like harsh soap, lubricant, and latex allergy can also cause it.
To confirm the cause,
A swab test is needed to check for the infection.
Biopsy for confirmation of diagnosis.
Do urine tests and blood tests to rule out the possible causes.
Infection can recur if blood sugar levels are not under control. High blood sugar level increases sugar levels in urine. When this urine containing sugar dribbles and stays on the glans penis, it becomes a friendly place for yeast and bacteria to feed and grow, which results in infection.
If recurrent infection,
The cause has to be identified and treated.
Do all tests, as mentioned previously, with BSL (Biosafety level).
Get all STI (sexually transmitted infection) panel tests done, including HIV (human immunodeficiency viruses).
Follow-up for any doubts.
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