Dr. Rakesh Kumar Bahunuthula
Dermatology
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 developed some scaly blackish, thick layer on both sides of my glans penis nearly four months ago. I consulted a dermatologist, and he said it is balanitis due to bacteria and fungus. He prescribed creams like Clotrimazole, Fucidin, and Lulifin. I continued applying it for a month but with no improvement. Then I went to another dermatologist, and he said it was frictional dermatitis and gave me a corticosteroid cream Efficort and Cetaphil moisturizer for application, but there was no improvement. I want to get rid of it. Also, he gave me tablets Azee and Fluconazole but with no improvement. I am attaching the pictures for your reference. Kindly suggest a treatment.
Hello,
Welcome to icliniq.com.
I have seen the pictures attached (attachment removed to protect the patient’s identity). The area appears a little thickened and pigmented. This is called lichenification. It results from any itchy or repeated frictional activity or infection. Right now, there does not appear to be any focus on infection. Unless the pigmentation is bothering you, there would be no need even to treat it as it would resolve over a period of time.
Thank you.
Treatment plan
Preventive measures
Patient's Query
Hello doctor,
I have already used Clotrimazole cream before, but there was no improvement.
Hello,
Welcome back to icliniq.com.
The Clotrimazole cream is not for treatment. It is only to prevent secondary infection from using other creams.
Thank you.
Patient's Query
Hello doctor,
Is my condition due to frictional dermatitis or scabies?
Hello,
Welcome back to icliniq.com.
Lichenification is an end-stage. It appears most commonly as a result of chronic rubbing or scratching. Scabies generally involves the scrotum with multiple itchy nodules. Frictional dermatitis can be a possibility, although the site is less common. I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
Would the use of a moisturizer at the site of infection help?
Hello,
Welcome back to icliniq.com.
Yes, Clotrimazole would help in both ways.
Thank you.
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Dermatology
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