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Noticed Red Flat Blotch On Penis After Unprotected Sex. Should I Be Worried For Balanitis?

Posted on Thu, 4 Apr 2013

Question: Hi Doctor - I recently had unprotected male-to-male sex with a new partner (non-penetrative, genital-to-genital contact only) in tropical conditions & 3 days later noticed a red flat blotch on the glans (like WWW.WWWW.WW which is unchanging after 10 days though I think it is gradually fading. It appears dry constantly. Balanitis seems a reasonable diagnosis but I am circumcised. It follows a period of 3wks where personal hygiene wasn't compromised as such but due to limited availability of rinsing water, there may have been soap residues. Thank you

Answered by Dr. Sankaranantham Murugan (3 hours later)

Hi XXXXXXX
Welcome to XXXXXXX
Thanks for posting your query.

Even in the circumcised individual also irritants like soaps, antiseptic lotions or some type of topical preparation could be able to cause such Balanitis.
Sometimes forcible rubbing also may be likely to cause such lesion.
If you have some previous infection with Herpes (HSV 2) or yeast infection, this could also be possible to manifest following some sort of sexual trauma. Diabetes also has to be ruled out as it can predispose yeast infection. If it is due to just an abrasion or due irritation, spontaneous remission is also sometimes possible.
If you consult your Dermatologist, he/she will help you for further investigations and management.
Get well soon.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (5 minutes later)

Thank you Dr XXXXXXX I have not presented to a Doctor, Balanitis is my own unqualified suggestion - please confirm you were aware the diagnosis was mine & unqualified & advise other possibilities if appropriate?

Cheers
XXXXXXX

Answered by Dr. Sankaranantham Murugan (15 minutes later)

Hi XXXXXXX
Welcome back with your follow up questions.

You have sited an address in your query. Similar lesions are Balanitis only as you have rightly pointed out.
Balanitis means inflammation of Glans penis. Not exactly an ulcer where an discontinuation of epithelium will be present. It may be a localized or uniform redness of Glans penis.
There are so many causes for Balanitis as I have discussed with you.Systemic drug allergy also can cause similar lesions.
Your Dermatologist will definitely be able to treat your condition totally and you will be relieved.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (24 hours later)

Thank you again Doctor. Regarding the possibility of drug allergy, 10 days prior to the inflammation appearing I underwent 2 full days of conscious sedation & vast amounts of anesthetic for dental implants, bridgework etc. To now it has been assumed the jaw drilling (which was extremely painful, despite anesthetics) caused paresthesia that has since persisted. Numerous scans reveal close but not direct nerve contact & the prognosis is that the paresthesia will gradually diminish over approx 6mths. I now see there are cases of paresthesia as a result of certain anesthetics. If this is anything you (or a colleague) would care to comment on, please do.

I don't have a dermatologist & at this stage don't envisage seeing one. Is it reckless to assume the balanitis will clear up of its own accord in due course?

Thanks again
XXXXXXX

Answered by Dr. Sankaranantham Murugan (17 minutes later)

Hi XXXXXXX
Welcome back.

Parasthesia caused by procedures or due to drugs have nothing to do with your problem over penis. But the anesthetic drugs that can cause parasthesia or anesthesia can cause drug reaction.

Balanitis if mild and due to irritation or allergy, it may likely to resolve spontaneously within few days of withdrawal of the drug or irritants.
If you could be able to send the pictures of your lesion, more information can be given.
Get well soon.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (17 hours later)

Thank you Doctor - yes, I wondered if a drug (anesthetic) reaction could be causing both symptoms. I completed the medications from the dental procedure 16 days ago. The balanitis appeared 12 days ago. I had the sexual contact 15 days ago. Please refer attached picture.

Thank you
XXXXXXX

Answered by Dr. Sankaranantham Murugan (1 hour later)

Hi XXXXXXX
Welcome back.

I saw the picture sent by you.
It is well circumscribed reddish lesion where other parts of your Glans penis is absolutely free.

It is not fit with drug reaction which will be slightly diffused over the periphery of the lesion with a slight violet tinge. It is not related to any infection like yeast or any other STD. It may either be due to some irritation or due to skin problems like psoriasis, Lichen planus or some rarer causes of balanitis like Plasma cell balanitis or Erythroplasia of Queyrat etc. You just apply some steroid creams as per the advice of your dermatologist. If is not responding a biopsy of the lesion will help.
If you have further queries I will like to answer the same.
Dr S.Murugan

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sankaranantham Murugan (3 hours later)

Great thank you Doctor, much relieved it doesn't appear to be an STD. In view of not having a Dermatologist, could I just try whatever steroid cream a pharmacy can sell without prescription / or similar?

Cheers
XXXXXXX

Answered by Dr. Sankaranantham Murugan (6 hours later)

Hi,
Welcome back

You can try with steroid cream available in the pharmacy without a prescription.
Good luck to you.
Dr S.Murugan

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar