Q. I have a purplish rash on my penis. Could it be an STD?

Hello doctor,

After a night where I blacked out from drinking, I may have had sexual intercourse with a woman I do not know. Later, I got a purplish rash on the bottom ridge of my penis head as well as some dark spots on the shaft. My scrotum is red except for a flesh-colored stripe down the middle. I have attached an image for your better understanding. I have tested negative for all STDs including HIV. Also, I have been on Ketoconazole cream and pills for four weeks with little change. I stopped taking the pills because of its side effects on the liver. My physician asked me to see a dermatologist but, I cannot get an appointment until the next month. I have also noticed that, even after ejaculating, I still get some discharge, which has never happened. I also have these dark-colored veins on my scrotum, which were not there previously. I think it is a yeast infection but not sure why the pills and cream did not work.

Hello doctor,

Thanks for replying. I am not using any antiseptic soaps. I do a lot of exercises, which results in a lot of sweating. These symptoms came about one or two days after the initial incident. I also noticed that the rash is only on one side of my scrotum. There is a flesh-colored line going down the middle, and the skin of the scrotum appears to be saggy. I am not sure if this is related but, I have a tingling sensation in my left foot. My anus also tends to be sore, but that appears to come and go. It almost feels like hemorrhoids. I have attached all my test results. The RPR test was initially positive, but a further test confirmed that I did not have syphilis.

Hi doctor,

Thank you for the reply. I will try your treatment plan for the next few weeks to see if it clears up. I have tried Clotrimazole cream in the past but will try again. One more symptom that I did not explain is that the veins in both my penis and scrotum are now dark purple. This was not the case before. I am 100% certain that the color of these veins was not this dark previously. I just wanted to make sure I listed this as a symptom. Also, I realize that some of this might be psychological as I put myself through torture while awaiting the test results of the STD test and also just the guilt of the entire situation. I realize that STD is probably not the cause, but could it be that if I did have sex, the person could have had a yeast infection that was passed on to me? If so, what would the treatment be for that? I feel as though the infection, while not an STD, is something internal and not just an infection of my skin. Does that make sense?