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Inflamed, red area on foreskin which splits, itchy rash. Applied Canestan cream. STD clear. What can you advise me on this?

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Practicing since : 2005
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Hi there, would much appreciate your advice. For over 12 months now I have been suffering with an inflamed, red area to the end of my foreskin (which then splits), and a red, itchy inflamed penile rash. I have tried all kinds of things to resolve this, including going to see my GP on several occasions; I have tried a 10 day course of canestan cream, had courses of oral antibiotics, used fungal cream, been screened at GUM (as advised by my GP - all clear). It is driving me mad, my girlfriend is unaffected and has also been screened at a sexual health clinic (all clear). My underwear seems to "rub" when i walk, and is affecting my everyday life. What can you advise me on this, as my GP seems to be at a loss as to what to do. Thankyou.
Posted Tue, 22 May 2012 in Skin Hair and Nails
Answered by Dr. Sudarshan 1 hour later

Thanks for writing in.

After going through your query, first thing that comes to my mind is balanoposthitis. It is inflammation of foreskin and glans penis. It can be due to bacterial, fungal infection or an allergy to latex in condom or due to other causes.

To be able to help you better, it would be great if you can answer the following questions:

1. Since when you have this problem?
2, Are you on any drugs presently apart from zopiclone?
3. Do you have any oral lesions (lesions in the mouth)?
4. The genital lesions that you have described are ulcers or raised lesions?
5. Do you have any abdominal problems?
6. Do you have any scalp or nail abnormality?
7. Do you have any other symptoms like fever/sore throat/other joint pain?
8. Are you diabetic? Have you checked for sugar levels recently?

Please reply to the above questions so that I can help you further.

Photographs of foreskin lesion (close up, distant and lateral) in good light can be helpful.
Photos can be uploaded through "Upload your images" section on the right

Awaiting your response.

Dr Sudarshan
Above answer was peer-reviewed by
Follow-up: Inflamed, red area on foreskin which splits, itchy rash. Applied Canestan cream. STD clear. What can you advise me on this? 27 hours later
Hi there,

Many thanks for your speedy response, as advised I have attached 4 photographs which I hope will be of help. In response to your questions:

1. I have had the split to my foreskin for many years (approximately 6 years), this does occasionally heal but does eventually split again. The blotchy red rash to my penis I have had for about 18 months.

2. I am on no other medications other than the Zopliclone.

3. I have no oral lesions, I can not recall ever suffering from this.

4. The genital lesions I describe are more of a slightly raised blotchy red rash, there are no ulcerated areas; all skin is intact and unbroken.

5. I do not suffer with any abdominal problems.

6. I have no scalp or nail abnormalities.

7. I have no fever / sore throat / joint pain.

8. I am not a known diabetic; I haven't had my blood sugar levels checked, however.

I am particular about my personal hygiene, and have begun to use non-perfumed soap/products in case this may be a contributory factor. I do sometimes find that it does ease off (with regards to the itching and discomfort), although the "blotches" do remain.

I hope that this is helpful, and look forward to your response. Many thanks in anticipation. regards,
Answered by Dr. Sudarshan 28 minutes later

Thanks for providing with the necessary details and the pictures.

Though the images were a bit hazy, I was able to view it. The close possibility that I can think of is balanoposthtis. However there can be other conditions with similar presentation. A careful examination of the affected region by a competent dermatologist might help in ruling out other cause.

As discussed in my initial reply, balanoposthtis can occur due multiple organisms, but candidial (yeast) infection is commonest.

Treatment can be in form of antifungal (fluconazole) might help in such cases. Application of beclomethasone + clotrimazole cream application twice daily for 15 days can give added benefits.
You can take these drugs after consulting your dermatologist.

In addition I also suggest you to undergo fasting and post meal sugar levels as balanitis are common in diabetics.

If you have recurrence of this problem you may undergo circumcision.
Circumcision involves surgical removal foreskin, which will be effective in treating your problem permanently.

Hope this helps you. Let me know if you have any other query.
If all your queries are addressed, please accept the answer and close the discussion.

Wishing you speedy recovery.

Dr Sudarshan
Above answer was peer-reviewed by
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