How do I manage a white patch near the urethral opening?

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

The image (attachment removed to protect the patient’s identity), has been reviewed. If there has been unprotected sexual contact, it is important to rule out sexually transmitted infections.

I would recommend the following tests:

• Treponema pallidum hemagglutination assay (TPHA).

• Herpes simplex virus (HSV) types 1 and 2 – nucleic acid amplification test (NAAT) or reverse transcription polymerase chain reaction (RT-PCR).

• Herpes simplex virus immunoglobulin G (HSV IgG) testing is not useful for diagnosis in this context.

• Urine polymerase chain reaction (PCR) for chlamydia trachomatis and neisseria gonorrhoeae.

• Human immunodeficiency virus (HIV) 4th-generation antigen/antibody screening.

• Hepatitis B surface antigen (HBsAg).

• Urine complete analysis, urine culture, and sensitivity.

• Complete blood count (CBC).

• Erythrocyte sedimentation rate (ESR).

These investigations help rule out common causes of genital lesions, discharge, or irritation following possible exposure. If there has been no unprotected sexual exposure, the following management may be considered based on symptoms:

• Apply Mupirocin ointment locally twice daily.

• Take Doxycycline 100 milligrams twice daily for five days after food.

• If there is significant itching, suggesting a fungal infection, apply Clotrimazole with Beclomethasone cream locally twice daily.

• Take Cetirizine once daily at night for itching.

General genital hygiene advice:

• Wash the genital area twice daily, in the morning and at night.

• Use normal room-temperature water.

• Avoid very hot or very cold water.

• Avoid harsh or high pH soaps.

• Keep the area dry and avoid tight clothing.

If the lesion persists, increases in size, or is associated with pain or discharge, further clinical evaluation by a dermatologist or urologist is recommended.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.