Dr. Shama Naaz
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 have a single ulcer on my penis shaft where the doctor prescribed Keflex and Bactroban ointment. He also has a swab for chlamydia and blood tests for HIV, syphilis, hepatitis, etc., which all came back negative. I applied Bactroban on the ulcer and around the skin and decided to masturbate. About 30 minutes later, a red rash with tiny vesicles appeared. The next day, I tightened my skin and burst them quite quickly, releasing clear fluid, leaving a small cut. The cuts are now painful to touch. The rash and tiny ulcers look better immediately after moisturizer or applying cold compression. It does not seem to be itchy. The first ulcer I had now has been swabbed for HSV-2, but the doctor said it is unlikely to be that, but an infected bacterial infection. I am concerned about the present rash.
Hi,
Welcome to icliniq.com.
Ulcer on the shaft of the penis can be due to different reasons like herpes genitalis, local trauma, or secondary bacterial infection, and some STDs (sexually transmitted disease). Was there any pain associated with the appearance of an ulcer? Is there any painful or painless lump in the groin area? For the rash, is there a burning sensation before the appearance of vesicles and redness? Do you have a history of unprotected intercourses recently or any urethral discharge? Did you have a similar reaction when you use Bactroban cream?
The Probable causes
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Differential diagnosis
Probable diagnosis
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Patient's Query
Thank you doctor,
There was no pain on the initial ulcer. No burning or tingling before the secondary rash. No lumps in the groin area and no discharge. I am sexually active. And this is the first time I am using Bactroban. This is what the rash looks like after two days from the first photo. Could this be eczema?
Hi,
Welcome back to icliniq.com.
Burning and itching before the onset of rash is commonly seen in herpes, but some patients may not complain. So, I would not rule that out without seeing the report. Making a confirmed diagnosis is essential in herpes because, without treatment, there is a chance of recurrence. According to your history, rash appearance came after applying Bactroban and coupled with friction in the area due to masturbation. It could be irritant contact dermatitis, which will go away with time and topical medication only. There is no history of urethral discharge or lump in the groin area, and your test reports are negative for HIV, syphilis, and chlamydia.
The Probable causes
Investigations to be done
Differential diagnosis
Probable diagnosis
Treatment plan
Preventive measures
Regarding follow up
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Dermatology
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