Brief Answer:
Missing history? investigations?

Detailed Answer:
Hello

Thank you for posting on HCM.
I appreciate your concern regarding the skin condition and I will make sure your problem is solved in rightful way.

From the clinical photographs I can think to 2 possibilities -Genital Lichen planus and Nodular scabies.

But the definitive diagnosis rests upon actual physical examination.

Thus i would insist you to answer some missing points in history :

1.Any symptoms associated with the lesions?
2. Any discharge from per urethra?
3.Painful swelling over groin area?
4. History of recent sexual exposure? Protected or unprotected? known or unknown partner?
5. History of similar complain in past?
6. Any burning sensation or ulcers in mouth?

Additionally I would insist you to get following investigations done as the lesions are on genitals:
1. Serum VDRL test in serial dilution
2. serum HIV antibody test

Hope you will revert soon with the details asked for.
Thank you
Dr Hardik Pitroda

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Brief Answer:
genital warts, podophyllotoxin, cauterization

Detailed Answer:
Hello again,
Okay, from the history it seems you have got genital warts most probably.

Warts are type of growths on skin and mucosa due to a virus called HUman papilloma virus. The infection is contracted mainly by direct skin-to-skin contact and in your case you may have got it from unprotected intercourse.
Usually warts are harmless but they have tendency to spread as they are contagious and thus mandates proper treatment.

Generally, in my patients I recommend local application of podophyllotoxin 20% over warts under my supervision every week for atleast 6-8 sessions.
Other medications which are helpful in genital warts are Imiquimod application thrice a week or 5-fluorouracil gel to be applied daily over warts.
Some oral drugs like levamizole and zinc can also help in treating warts.
Resistant warts may require removal by a dermatologist via a simple machine called radiocautery.

I would insist you to abstain from intercourse till the lesions subside and if so you indulge, make sure you always use barrier contraceptive like condoms.

The warts have high tendency for recurrence thus i would also like you to avoid promiscuous sexual behavior (if any !).

Kindly revert back with thorough discussion with your dermatologist and your investigations.

Thank you
Dr Hardik Pitroda

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Brief Answer:
No OTC products

Detailed Answer:
Hello again,
I am afraid to say there is no OTC powder or cream that can help you with this.
Thus I would suggest proper management under supervision of a dermatologist.
HPV infection is completely curable but it takes years before the virus gets completely removed from your skin but nothing to worry. You should take proper treatment when there is a recurrence and take necessary precautions which mentioned in previous answer.

Hope my answer was satifactory to your expectations and kindly spare some time to rate the answer and drop your valuable review at my profile page
Thanking you
Dr Hardik Pitroda

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Brief Answer:
Oral acyclovir,

Detailed Answer:
Hello,
The last picture of your genital which you have posted has made me to change my diagnosis.
After keen observation on the photograph in full zoom, I can appreciate small pin-head size blisters on your penile shaft.
If that is the scenario, you are definitely having Herpes progentialis.
Herpes progentialis is a viral infection caused by Herpes simplex virus and is sexually transmitted in most of cases. This infection presents with clusters of tiny blisters which rupture to leave behind erosions and burning sensation.
The standard management I recommend again starts with investigations like VDRL, HIV but additionally you have to go for HSV1 and 2 antibody test.
As for the treatment, its very easy to treat if properly diagnosed.
I recommend a 7-10 days course of oral acyclovir 400 mg thrice a day along with local application of antibiotic cream like fusidic acid.
For irritation, diclofenac and anithistamincs can be added.
Precautions include abstinence from sexual act till complete resolution, parter examination and investigations, avoid promiscuous behavior and use of barrier contraceptive when indulging in sexual act with unknown person.
Hope you will visit your dermatologist soon and discuss all the matter that I have told you.
Wish you best of health,
Thank you
Dr Hardik Pitroda

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