Dr. Nidhin Varghese
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
Hi doctor,
I have had unprotected oral sex, and since then, I have been urinating more frequently, and my urine is often clear in color a couple of times a day even though I do not drink water. I also often get an extreme urge to urinate and have some strange spots that would not go away for months. Kindly help.
Hello,
Welcome to icliniq.com.
I would suggest take syndromic management of "urethritis." Take tablet Azithromycin 1 g immediately in one single dose and tablet Cefixime 400 mg immediately. Now coming to those pictures (attachment removed to protect patient's identity), those red pimples look like folliculitis. Which areas are the photographs of? I am not able to make out the body part in all of the pictures. Thank you.
Patient's Query
Hello doctor,
Thank you for the response.The largest one is just below the belt on the front left, one on my nose, the big acne on my back, and one about one cm away from the corner of my mouth. I also have these unusually large bumps on the back of my tongue, as you can see in the picture.
Hello,
Welcome back to icliniq.com.
So all lesions on the skin are folliculitis. Use a Benzoyl Peroxide soap for bathing. On these lesions, apply Mupirocin (2 % Mupirocin free acid) cream twice a day. Thank you.
Patient's Query
Hello doctor,
I highly doubt it just that. They have all appeared after having received unprotected oral sex. I also randomly get pins and needles in my left toes, which last quite long; recently, I started getting pain in my right hand and foot, possibly arthritis. Kindly suggest.
Hello,
Welcome back to icliniq.com.
Pins and needle sensations need to be evaluated. It is difficult to comment as there can be a lot of reasons for it. Though very unlikely to be related to an STI (sexually transmitted infection). A simple gram stain can rule out the pustules and will show its infective or not. You will be able to see the bacteria on the slide. Joint pain, pins, and needle sensations are seen in the late stages of STI (like gonorrhea and syphilis). They do not appear early. So it is doubtful to be a presentation of STI at present. However, reactive arthritis can happen secondary to a urinary tract infection. Generally, with urethritis and arthritis, there will be conjunctivitis too. Do you have any eye-related complaints? Anyway, antibiotics should help with this too. Thank you.
Patient's Query
Hello doctor,
I took a urine test and had no infections also, and this does not necessarily have to be early stages as the oral sex happened roughly six months ago.
Hello,
Welcome back to icliniq.com.
Take tablet Azithromycin 1 gm and tablet Cefixime 400 mg immediately, which would clear gonorrhea and chlamydia (syndromic management), and urethritis. Get a basic Gram's stain of the pustules. If gram-positive, it is bacterial folliculitis, and if gram-negative, you can suspect STI (sexually transmitted infection). Thank you.
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Dermatology
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