Dr. Khant Shahil Ramesh Bhai
Urology
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
Hi doctor,
For the second time I have suffered a rash on the glans of my penis in this year. This time the rash was more intense in color. There has never been any itching or pain associated with this rash. But, just a scary looking color. I was tested for all STD and STI infections before a month and it was negative for HIV, chlamydia, gonorrhea, syphilis, HPV, etc. This was completed by full blood test and urine sample. I am 36 years old and married. My sexual partner has been the same for the last 10 years. I do have a tight foreskin, which cannot be retracted the whole way over the head of my penis, but can come back about 75% of the way. Over the past three weeks, the rash has subsided and the redness is slowly going away. I have used Hydrocortisone 1% for two days and Canesten cream for two days. I also have Trimovate cream, which was prescribed to me for the first occurrence of this rash earlier this year.My main concern is penile cancer, although rare from what I have read, it worries me that this could be a tumor of some sort. Or is this a case of balanitis? The other concern I have is the white markings on my penis, which have developed over the past one month. My personal hygiene is excellent. I do not use soaps on my penis glans and just warm water twice a day. I have attached some images of the rash. I would appreciate any advice.
Hi,
Welcome to icliniq.com.
First of all, do not worry as you do not have penile cancer. This is a recurrent attack of balanoposthitis. You should get tested for diabetes. For tight foreskin, you need circumcision. Also, if you are using a condom or any jelly during intercourse, then that might be irritating your penis. So, try to avoid condom and do not apply any other material on your penis.
Investigations to be done
Patient's Query
Hi doctor,
Thank you for your quick and informative reply. Can you tell me, other than circumcision, what can I do to improve the problem in the short term? Is there a time frame for healing? The white markings that appear to be hardened, will they eventually disappear?
Hi,
Welcome back to icliniq.com.
It should heal in two to three weeks of time. You have to maintain proper hygiene. Clean your penis two times a day with water. Do not apply soap or any other irritants. Get the blood test done, which I have suggested.
Patient's Query
Hi doctor,
My symptoms did appear to clear up to some extent. This week, I had unprotected sex with my wife. The next morning, I presented with further symptoms. I did not use any lubricant, So I am hoping that this ailment is due to friction. Can you please tell me if I should be worried about the whitish matter on my penis head? I have no pain, itch or discharge. Thanks for your help once more.
Hi,
Welcome back to icliniq.com.
I have gone through the images sent by you (attachment removed to protect patient identity).
You had improvement in the rash as visible from images. I suggest it is nothing to worry at this point because your rash is almost cleared. The main thing is you should keep proper hygiene. You should also wash your penis correctly after sexual intercourse. You can apply Mycogen 2 (Nystatin and Triamcinolone) ointment twice a day with the consent of your dermatologist. It also seems from the image that you have a tight penile foreskin. Friction during intercourse may also cause this. So, try the above ointment and conservative measures.
Patient's Query
Hi doctor,
Thank you yet again for a speedy reply. I do not know to improve my hygiene any further. I wash the area two or three times a day and dry correctly. My biggest concern is the white area in the middle of the new red marking. Could this be lichen planus? While it causes me no pain, it is somewhat worrying to look. I am also assuming I have nothing contagious, as I am trying to conceive a baby with my wife. Thanks again.
Hello,
Welcome back to icliniq.com.
I have seen all three images sent by you. Two images look good to me. In one image, there is a slight white area in the middle of redness which looks like a fungal infection. Definitely, it is not contagious or cancer so do not worry. You will not have problems with conception at all. You should clean your penis head by pulling your foreskin. Clean it with water only and no soap. You can apply the above ointment. I suggest it should go with above ointment. If not, then better consult a urologist to examine you and have a second opinion. It is also not lichen planus, so do not worry. Thanks.
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