Dr. Dilip Kumar Meena
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 got an infection in my penis. First, the symptoms started minor with itching. In a couple of days, it got worse, and it pains a lot. The head of the penis had turned red with inflammation. There seem to be some cuts on the side of the penis with fluid oozing out under the head. It burns when I pass my stools and pains to when something touches it. I am even having a problem wearing my underwear due to pain. Currently, I am applying Lofatin cream.
Thank you.
Hello,
Welcome to icliniq.com.
I understand your concern. It looks like you have a drug reaction, known as fixed drug eruption. Have you taken any medications just before the onset of this condition for any health issues like pain, fever, or stomach upset? Is this the first time this happened, and are any other body parts involved? Please revert back with answers so that I can prescribe you the proper treatment.
Thank you.
Patient's Query
Hi doctor,
Thank you for your answer.
I had a stomach upset four days back, and I took O2 (Ofloxacin and Ornidazole), both tablets daily for three days. This started just after I took this O2 dose. Please advise a proper treatment for this as I am facing pain. The skin has become extremely touch-sensitive, with a burning sensation on passing stools (as the skin is exposed on the tip). I have attached the latest pictures of the infection. I am currently applying Lofatin + T bact cream two times daily for the past three days, with sometimes coconut oil on it in between.
Thank you.
Hello,
Welcome back to icliniq.com.
I saw your spread of infection (attachment removed to protect the patient's identity), so start following medications from today and take the medications for five days. Take tablet Wysolone (Prednisolone) 50 mg once a day after meals. Use Cream Momate (Mometasone) apply twice a day and cream T-bact (Mupirocin). Take tablet Rabeprazole (Aciphex) 20 mg before a meal once a day. You can apply both cream by mixing together.
Thank you.
Patient's Query
Hi doctor,
Thank you for your answer.
I forgot to add I also took one Meftal-Spas tablet on the first day of my stomach upset for pain with the O2. So should I avoid both Meftal-Spas and O2 in the future? Which tablet is likely to have caused the reaction?
Thank you.
Hello,
Welcome back to icliniq.com.
Fixed drug eruption with both the drug combination you have taken has been reported in the literature. Though it is more likely with O2 (Ofloxacin and Ornidazole combination), you better avoid Mefenamic acid (Meftal-spas) too.
Thank you.
Patient's Query
Hi doctor,
I have attached the latest pictures of my condition after three days of the prescribed medication. The condition seems to improve with less water oozing out,, but little pain and discomfort are still there. I would like to bring to your kind attention that there was an error from my end in the message regarding the dosage of Prednisolone. I have been taking 10mg instead of 50mg once daily. (I had ordered these medicines via phone and did not check until now. Also, I called the medicine store, and they said 40 mg is the maximum dosage available.) So I am confused about whether to go with the same 10mg dose ( as only two left) or increase it to 40 mg or 50 mg as prescribed and how many days to continue the course. Also, is it okay to cut off this medicine after the course, or do I have to reduce the mg daily?
I have been applying the creams as prescribed, but I wanted to ask if it is okay to apply coconut oil or Vaseline in the afternoon as the skin feels dry and coarse.
Thank you.
Hi,
Welcome to icliniq.com.
It seems to improve, but 10 mg is negligible when discussing proper prednisolone dose. 1mg/kg body weight is used to control acute inflammation.
Still, you can start 40 mg for the next four days, then reduce it to 30 mg for three days, and then stop. You should be better by that time. But still, if a little healing is left, we can continue creams only. When prescribed more than 40 mg, 40 mg and 10 mg tablets are combined.
Thank you.
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Dermatology
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