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Numerous red patches on head of penis. Do not itch or pain. Likely to be?

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Dermatologist
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I AM 43 year old male. Recently I noticed numerous red patches/blothces on the head of my penis. They are not bright red but more red than the skin. They dont hurt or itch. They are on the head and irregular shaped 4-5 in all. I have not had any unprotected sex and no other issues. I am circumcised. They have been there about a week and have not changed.

should I send a picture
Posted Thu, 26 Apr 2012 in Skin Hair and Nails
 
 
Answered by Dr. Bharat Chawda 2 hours later
Hi!,

Thank you for posting the query,

You have provided with good information regarding your skin problem and it is a very good description. I appreciate it.

I understood your problem however it would be good if you can send me a close up picture of the lesion .It is very important to see the lesions clinically here .

You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

But with history what you have submitted ,it seems to be a inflammation of sebaceous glands which could be induced by some friction.The second possibility is of a fungal infection.

A clinical picture would help be further to guide you better.

Awaiting for your reply.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.

Above answer was peer-reviewed by
 
Follow-up: Numerous red patches on head of penis. Do not itch or pain. Likely to be? 35 minutes later
I attached some pictures. The findings are acute in that they have just recently appeared within the past 7-10 days. The red areas are all over the penis head. They do not hurt or itch. They are fairly flat. I work on engines and thought I possibly had hydraulic fluid on my hands when urinating. My main concern is could this be a carcinoma but knowing it appeared acutely and is all over the head makes me wonder??
 
 
Answered by Dr. Bharat Chawda 11 hours later
Hi,

Thank you for the picture and your reply.

I have carefully gone through all the image links that you have provided. Unfortunately, the pictures were not that clear. However, if there is a history of contact with a chemical, then an irritant reaction could be a possibility.

I can assure you that it doesn't seem to be any kind of carcinoma. In fact, an irritant reaction is always acute .It doesn't seems to be a fungal infection either.

You can use a mild steroid cream like hydrocortisone cream like Acticort over the area for few days. I hope I've answered your query.
Should you have additional concern regarding the same, I would be happy to address it.

Please accept my answer in case you do not have further queries.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Numerous red patches on head of penis. Do not itch or pain. Likely to be? 8 hours later
i attached two additonal pics that are hopefully clearer. I am not sure I had contact with a chemical. I was saying I work with chemicals and I possibly had contact?

When I say acute I would say that it showed up within a few days because it is something I would have noticed if had gradually started to appear.

Hopefully picture 6 and 7 are better

I will try the hydrocortizone cream unless you have other findings
thank you for your help
 
 
Answered by Dr. Bharat Chawda 3 hours later
Hi!,

Thank you for the pictures again,

These pictures are more clear and I could make out the discrete lesions which are probably slightly raised.I don't see any scaling over the area,which rules out a fungal infection.

I would still stick with the possibility of a irritant reaction either to a chemical or a soap or any cleansing agent used (like may be salvon or detol if used any) .It can also be that the friction to the undergarments would be causing the same or may be you have changed or have used a new under garment.

It doesn't seems to be zoons balanitis either as in this we often see a much bigger erythematous patch .

I think you should start with a mild steroid cream for few days and see how it heals.

You can even consider consulting a competent dermatologist for physical examination, evaluation and to get proper medicines prescribed to you by them.

Hope I have answered your query, Should you have additional concern regarding the same ,I would be happy to address it.

Please accept my answer in case you do not have further queries.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.

Above answer was peer-reviewed by
 
Follow-up: Numerous red patches on head of penis. Do not itch or pain. Likely to be? 18 days later
I continue to have the areas on the head of my penis that is darker red/blotchy. I tried cortisone cream and it did not help. I went to my general doctor who said it looked like balanitits and prescribe antifungal cream. It has been about 7-8 days and I see some improvement but not a lot. The areas have become darker. I have attached some additonal pics. I have an area on the rim on the penis head that appears round in the photo. It may be from rubbing in my pants. I am still concerned with this. How long should this take to heal?
 
 
Answered by Dr. Bharat Chawda 1 hour later
Hi!,

Thank you for writing back,

Sorry ,but the last pictures you had send were not very clear.But as you mentioned that you have slightly responded to the anti fungal cream,I would advise you to take an oral anti fungal as well .Oral Fluconazole would be a better choice .

I would like to know which anti fungal cream has been suggested to you presently by the doctor.

While you are on anti fungal cream please avoid use of hydrocortisone cream as it would interfere with the treatment.

Usually a fungal infection takes 2-4 weeks to heal depending upon the sensitivity.

Kindly let me know how you are doing with the anti fungal cream.

Regards,
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Numerous red patches on head of penis. Do not itch or pain. Likely to be? 2 hours later
I added some much better photos. I have this for about 1 month. I started with cortisone and it did not help. I went to my gp and he said he thought it was fungal and put me on lotriman af. It seems to have lessened the redness? For the most part I have no itching or pain. I do have some discomfort after I apply the cream on the top edge of the XXXXXXX
 
 
Answered by Dr. Bharat Chawda 9 hours later
Hi!,

Thank you for your reply and the pictures.

The pictures are better and clear. I could make out that the lesion is healing and is leaving a darker shade. The dark shade or pigmentation is a sign of healing.

Lotrimin AF is Clotrimazole, an anti fungal cream. I think you should continue with the same. You can consult your doctor for an oral anti fungal tablet as well, which would further help in healing faster.

I hope and wish that your recover fast.

In case you have any further query, you can write back to me. Please accept my answer in case you do not have further queries.

Regards.
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Numerous red patches on head of penis. Do not itch or pain. Likely to be? 10 hours later
thank you for your time. I called my gp to ask for oral anti fungal. I am confused as to why it doesnt itch or burn? Is this normal for a fungal infection? I do have some whitening of my tongue which makes me think I have candida infection?
 
 
Answered by Dr. Bharat Chawda 13 hours later
Hi,

The absence of itching or burning is a little unusual in fungal infections and the absence of these symptoms made me consider other problems. But I would like to re-emphasize that such a presentation may be possible and this disease can be totally ruled out once a complete course of anti-fungal treatment has been completed and the response has been assessed.

Whitening of tongue may be caused by a fungal infection (candidiasis). If you can take an oral anti- fungal, it would take care of both the problems.

You can write back to me if you have any further query.

I wish you a speedy recovery.

Please accept my answer in case you do not have further queries.

Regards.
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
Follow-up: Numerous red patches on head of penis. Do not itch or pain. Likely to be? 16 minutes later
I have some mild tingling in my urethra opening but dont itch or burn on the head. What other problems would you consider?
 
 
Answered by Dr. Bharat Chawda 22 minutes later
Hi!

A mild tingling sensation over the tip of urethra could also be due to fungal infection. It can also be seen in patients who are diabetic, so kindly get a blood sugar level done.

At times moment you should only continue with the anti fungal treatment and observe.

Wish you good health.

Regards.
Dr.Bharat chawda XXXXXXX specialist, Dermatology.
Above answer was peer-reviewed by
 
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