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Q. I have white patches with dark outline in my genitals. Kindly help.

Answered by
Dr. Dilip Meena
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Oct 25, 2021

Hi doctor,

I had scabies during my childhood. I was diagnosed with psoriasis three years ago. Psoriasis involved my whole body, including my genitals. After treatment, it began to clear, but white patches appeared only on my genitals with a dark outline, it starts to spread to the right side. I have this white patches for an year. I started using Provate (Desoximetasone) ointment and Betamethasone dipropinate two days back.

Kindly guide me with the treatment.

#

Hello,

Welcome to icliniq.com.

I understand your concern. But there are no attached photographs in your message.

It is difficult to treat without seeing the lesion. It might be vitiligo or post-inflammatory hyperpigmentation.

Kindly send a picture of the affected area to assess the condition and suggest the appropriate diagnosis and treatment.

Take care.

Hello doctor,

Thank you for your response.

I am sharing the images.

Recently, I found an article online that mentioned the same issue. It says that dark skin is genital melanosis and the white patches were just within that, and it does not spread outside it. My genital hygiene during psoriasis and scabies lacked as I was a kid. My psoriasis is now off, but these patches remain. I do feel inflammation and burning sensation while urinating. Also, after completely emptying, I feel the urge to urinate in drops. I used Betamethasone to treat it. I am very much worried about this condition.

Would you please guide me with the treatment and prescribe ointments? Help me to know If I have UTI.

Thanks.

#

Hi,

Welcome back to icliniq.com.

Thanks for sharing the pictures (attachments are removed to protect the patient’s identity).

There are two possible diagnoses after looking at the pictures you shared.

The first is genital vitiligo, and the second is genital discoid lupus erythematosus (DLE).

As for the article you read, you do not have any genital melanosis except psoriasis and scabies.

I suggest you get ANA (anti-nuclear antibody) test done, which will help to rule out DLE to a certain extent.

For now, I suggest you Pimecrolimus 1% cream. It will work in both conditions.

Take care.

Hi,

Thanks for the response.

Does the vitiligo spread to the adjacent area? It has been more than a year, and it did not spread anywhere on the body except psoriasis. Also, will the cream resolve the white patches as well? And how much cream should be applied and when? Also, is there any chance of a UTI?

Thanks again.

#

Hi,

Welcome back to icliniq.com.

It is difficult to say if the vitiligo will spread. But genital vitiligo is usually an isolated occurrence.

There should be an improvement in the white patches with the cream but use it twice daily for six to eight weeks. Apply a sufficient amount of cream to cover the area and rub for few seconds.

For UTI, it is better to get a urine culture and sensitivity test done. Only then should the antibiotics be started, or else it will lead to treatment failure or antibiotic resistance.

Take care.


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