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Suggest Treatment For Scaly Skin On The Head Of Penis

Posted on Fri, 16 Jan 2015

Question: Hello Doctor...I have developed scaly skin on the head of my penis. It has become quite painful especially while working. All STD's came back negative. I got tested for them all. About 2 months ago I noticed a patch of dry skin on the head of my penis by the urethra. At this time it did not hurt...it progressively got larger and I put neosporin and hydrocortisone cream on it for a couple weeks. There is now throbbing and severe daily irritation but no itching except for some on the scrotum. I have also broken out in a small rash on my arms and leg that itch. Not sure if I could attach a picture, but the skin on the penis head is very scaly with slightly raised defined edges almost like snake skin. There were also times of burning and burning urination. This last month has been terrible and I don't see anything or pictures online of rashes that look exactly like this.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
It could be a scab after having a ulcer over glans penis.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have scaly skin over glans penis since 2 months.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Did this happened after unprotected sex?
2) Was there an ulcer over glans penis to begin with ?
3)Is it possible to upload photograph of your glans penis ?.

On the basis of what you have described it looks to be a healing ulcer over glans penis with formation of a scab.

You need to take broad spectrum antibiotic like Cefexine along with anti inflammatory drug like Diclofenac twice daily.along with topical antibiotic ointment like Neosporin twice daily.

Ensure to wash your genitals with warm water twice daily

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (48 minutes later)

Hello Dr. XXXXXXX
This is something that has gradually gotten worse since I first noticed it, not due to unprotected sex. There were never any ulcers or blisters, just the scaly skin that has become painful. I would like to send you a picture, but how do you do that in this forum? How could I send it for you to view? What are your thoughts on the dermatologists diagnosis of penile eczema? And also the idea of prednisone? Thank you

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
I personally do not think it to be penile Eczema.

Detailed Answer:
Hello
Thanks for follow up.
I personally do not think it to be Penile Eczema.and Predinisone cream will delay healing .

There is link to upload on first page of Health Care magic to upload photograph .

In the mean while continue taking treatment which I have suggested in my reply earlier.
Thanks and Regards.
Dr XXXXXXX

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

Follow up: Dr. Dr. P. T. Patil (40 hours later)

Dr. XXXXXXX ..I believe I was able to upload 3 pictures...please tell me what you think it could be. Thank you

Answered by Dr. Dr. P. T. Patil (4 hours later)

Brief Answer:
It is Ballanitis .

Detailed Answer:
Hello
Thanks for follow up and uploading photographs.

You have developed infection of glans penis ( Ballanitis).

Start taking treatment which I have suggested in my reply earlier.

It should heal up within 10 days .

Thanks and Regards,
Dr Patil.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. P. T. Patil (49 minutes later)

Thank you Dr. I have suspected that from the start although my family doctor didn't think so. I just finished a prescribed prescription for bacterial infections from my doctor, however my problems remain. Do you think it's more fungal related with need for a fungal prescription? I will say I always dribble urine in my underwear and my glans penis is usually always sitting in the dribble. I truly appreciate your help!

Answered by Dr. Dr. P. T. Patil (12 minutes later)

Brief Answer:
Get urine culture done to rule out UTI,

Detailed Answer:
Hello
Thanks for follow up.
Dribbling of urine could be due to either UTI or Over Active Bladder,

Get Urine culture done and take appropriate antibiotic as per culture report.

Take Tab Darifenacin once daily for 15 days .It will help to control dribbling .
Thanks ad Regards
Dr.Patil.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. P. T. Patil (27 minutes later)

I did have a urine test done and there was no UTI...does that rule out balanitis or not necessarily?

Answered by Dr. Dr. P. T. Patil (3 hours later)

Brief Answer:
It does not rule out Balanitis.

Detailed Answer:
Hello
thanks for follow up.

Absence of UTI does not rule out Balanitis.

thanks and Regards,

Dr XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. P. T. Patil (43 hours later)

Hello Dr. XXXXXXX ...I had my doctor prescribe me a single dose of fluconazole for balanitis...a couple weeks ago I took a bacterial prescription...I am two days in now and it is becoming apparent it may not be balanitis. I will give it some more time, but it seems to be getting worse. Any other ideas to what it could be? I am concerned that I broke out in a rash on arms and legs around the same time as this. There is also a wierd feeling in and around my penis head. My scrotum is starting to itch more frequently as well. Do you still not think it is penile eczema after seeing the pictures? This is really starting to take a toll on me...any other ideas would be welcome. Thank you. The rashes on arms and legs itch and disappear in a few days...this raised scaly skin on glans does not itch but is very uncomfortable...do you see any correlation between the two?

Answered by Dr. Dr. P. T. Patil (38 minutes later)

Brief Answer:
I do not think it to be fungal infection .

Detailed Answer:
Hello
Thanks for follow up.
Your clinical presentation does not look like it to be fungal infection .

However rash on legs and arms associated with lesion on penis can be allergic in nature .I would suggest you to consult your Dermatologist for re evaluation.

Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (26 minutes later)

Wow...I just sat and went to urinate at the toilet and after I was done what looked like urine kept coming out slowly for several minutes! My doctor is questioning prostatitis...I also leak A LOT of pre-cum after an erection. I also sometimes have difficulty maintaining an erection. Also get up at night about 2 times to urinate...it is becoming increasingly clear that I have prostate issues. I have an appointment with my urologist on XXXXXXX 6....about 2 years ago he said I had a slightly enlarged prostate and my father suffers from prostate issues as well. My question now is whether or not these issues could be tied in with the skin issues on my penis head? Ie. Sitting in the leakage in my underwear. If so what would be best to put on it til my appointment? Could this be prostate or penile cancer?

Answered by Dr. Dr. P. T. Patil (59 minutes later)

Brief Answer:
It is definitely not penile cancer prostate pathology needs to be ruled out

Detailed Answer:
Hello
Thanks for writing gain .Terminal dribbling of urination and difficulty in maintaing erection can be due to Prostatitis However it needs to be ruled out by clinical and digital rectal examination by a qualified Urologist and following basic tests ,
1) Semen Examination and Semen Culture .
2)Swab test of Urethral discharge fron urethra obtained after prostae massage
3) Ultrasound scanning of abdomen and pelvis
4) Trans Rectal Ultrasound Scanning( TRUS)
5) Serum PSA.

In the mean while continue taking antibiotics .

Your penis problem is not related to prostate problem .
Thanks and Regards.
Dr.Patil.

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

Follow up: Dr. Dr. P. T. Patil (56 minutes later)

Ok...I will definitely get that done...one last thing....is there anything else this skin condition could be besides eczema or balanitis? Also to rule it out, does it look like it could be any type of std? If so which one? Thank you Dr!

Answered by Dr. Dr. P. T. Patil (10 hours later)

Brief Answer:
It does not look like any STD.

Detailed Answer:
Hello
Thanks for writing again .
It does not look like STD .As a Urologist my knowledge about other skin conditions is very limited hence can not comment about it Thanks and Regards.
Dr.Patil.

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