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 am 30 years old. I observed something on the penis. It is like it burns and is red in color. I do not have any pain or itching. I started applying Clobesym-OZ cream. Now it seems some transparent shiny skin developing on it and also other parts of the skin around it started becoming shiny and scaly. I have uploaded the image. I do not have any pain or itching. My blood sugar is normal. Please tell me what it is, the seriousness, the remedy and how long will it take to improve.
Hi,
Welcome to icliniq.com.
I have seen the image (attachment removed to protect patient identity). Clobesym (Miconazole) is a potent steroid based cream and whatever you are noticing now are the side effects of steroid usage.
Patient's Query
Thank you doctor,
What should I do and what is this problem with the red patch? How will it go? I used a cream for this and result is what is reflecting in the image. Please tell what is this red patch and how it has developed.
Hi,
Welcome back to icliniq.com.
The possible differentials for your red patch on the genital could be genital lichen planus or genital psoriasis or lichen sclerosis or candidiasis. However, the application of steroid would alter the original picture making it difficult to establish a definite diagnosis. First of all, we need to give a washout period for the steroid effect to go, which would take at least two weeks. Only then a possible diagnosis can be concluded. However, there is nothing to panic, as the condition appears benign and totally treatable. It is best advisable to stop all topical creams that you have been applying and use as prescribed. Also, mention if you are sexually active and have had any exposure recently.
Treatment plan
Patient's Query
Thank you doctor,
So should I stop using the Clobesym? And wash it for two weeks and then start the plan or I can right away start the treatment plan? Please check the attached initial image before I started using Clobesym-OZ cream. Also, I never had sex with anyone, but I am sexually active.
Hi,
Welcome back to icliniq.com.
Yes, you need to stop using Clobesym cream right away. You need to start the treatment that I have prescribed as early as possible. There is no need to wash and wait for two weeks. Avoid washing the area with any antiseptics. Wash out period means time to allow the effects of previous treatments to wane off. It looks mostly like a patch of genital lichen planus or genital psoriasis. You can start using Onabet cream.
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