What causes bruises on foreskin of penis?
I need more clarifications
Hello. Thank you for writing to us
I am Dr. Kakkar (MD, SKin and Sexually transmitted infections). I have read your query and I have also reviewed the Image.
I can see a few erosions/ breaks on the skin and underside of foreskin. I would like to keep possibilities of either genital herpes Or candidal posthitis.
I would like to know a few more details from you in order to help you better..
Do you have any symptoms like itching? pain?burning sensation?Or burning on passing urine?
Are you sexually active?If yes, do you have a single or multiple sexual partners? when was your last sexual contact? How ofetn do you use a protection/condom?
I suggest you to use a clotrimazole cream and single dose of fluconazole
These are not bruises. They are erosions i.e breaks in the continuity of epidermis. This could very well be a candidal infection / posthitis (i.e inflammation of prepuce due to candida). Candidal posthitis classically presents with vertically oriented cracks along the rim of prepuce. By looking at this Image some of the cracks do look that they are vertically oriented. Moreover smegma promotes candidal growth and itching is a common symptom of candidal posthitis.
Genital herpes too presents with erosions on genital skin and therefore I am considering this possibility as well.
Right now I would suggest that you use a topica antifungal cream e.g clotromazole 1% cream, twice daily, as an empirical treatment for candidal infection/ posthitis. However, you should get back to me in 3 days if it does'nt respond or worsens. Ideally I would also suggest a tablet of an Oral antifungal i.e Fluconazole 150 mg. Just a single dose is required. However, fluconazole is a prescription drug and you need to talk to your primary physician for help regarding a prescription for fluconazole.
However, I would also like you to get tested for genital herpes later with an ELISA blood test for IgG antibodies for hsv type 1 and type 2. Genital herpes is an STD and is usually acquired by sexual contact with an infected sexual partner.
Continue with the cream for a week.
You should continue with the cream for a week. No need to take anymore tablets as single dose is sufficient.
These breaks are part of the clinical presentation of candidal infection and are due to edema and inflammation that accompanies candidal infection.
No specific measures for preventing this in future except that you should maintain proper hygiene and don't allow smegma to accumulate.
However in case you develop frequent recurrences in future you should get your blood sugar checked.
You should also go ahead with Hsv testing at 12 weeks as suggested earlier.
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