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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Red Rashes On The Foreskin Of Penis?

Hello - I may possibly have a STD. I m male, 59, heterosexual, teach at a college, have not been sexually active for 2+ years, and have twice been tested for herpes and HIV – both negative. Vegetarian/vegan for almost 40 years, low BMI, very fit, never a smoker. At least annual visits to Panama & Brazil (2008-2014); combined 8 months in Ecuador and Colombia (mostly Colombia) in 2015. (The symptoms I describe below may occur less frequently when I’m away from my home in upstate NY – doubt it’s Zika, etc.) My symptoms are: intermittent rashes (red, non-itchy, non-painful but slightly sore, patches on the glans and inside of the foreskin of my penis; no discharge), often weeks apart, but sometimes more frequent. The patches have persisted unusually for about 2 weeks now, on and off. Although I have had small ulcers in these locations in the past – these rashes are different (or perhaps smaller, coalesced, ulcers). I have had both these red rashes and small ulcers going back to my 20s, but only very infrequently (again – testing negative for herpes twice – once in my twenties from a urethral swab and recently from a blood test). Over the last few years these symptoms have become more frequent, and are associated with feeling a little run down (mild headaches, very mild cold-like symptoms – isolated sneezing and coughing – but very mild). I’ve also noticed that my flaccid state is smaller when these symptoms are present. In the last 4 years I’ve twice had a full blood workup with nothing showing except transitory low Vitamin D and B12 (short term high dosages prescribed; multivitamin taken for 5+ years). (List of tests below.) My GP and a specialist both thought my symptoms were not of an STD and suggested the periodic malaise could be a symptom of mild depression. But neither seem to have an explanation for the very specific STD-like symptoms - other than they might be a symptom of mild depression. (The doctor for my annual skin-check last week didn t think this was likely and suggested additional STD testing.) I’d very much appreciate any additional thoughts. Thanks. Last blood test October 2014: Ana Screen W/Refl, Anca Panel, CCP lgg, CMV lgg And Igm, Coxsackie A AB Panel, CMP – complete panel (14 test), CBC+Hematology review, C-reactive protein, celiac disease panel, Cortisol Am, Compliment total (CH50), Cryoglobulin QL W/RFX, HIV ½ AB Eia positives RFX, Esr sedimentation rate, Hla B27 antigen, Hepatitis acute panel, Immunoglobulins A/E/G/M serum, Iron & ferritin, MMR3, Vit B12 binding capacity, Vit B12 & folate serum, Zinc QN blood, West Nile Igg/lgm, Vit D 25 hydroxy, Ua complete, Toxoplasma panel, Testosterone FR/Tot LCMSMS, TSH + free T4, Rickettsia AB panel W reflex T, Urine 5-Hiaa quant random. (PS Just noticed Lyme isn’t listed.)
Mon, 6 Apr 2020
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General Surgeon 's  Response
Hello,

As per my surgical experience, the rashes over the foreskin of penis indicates possible balanitis through some sort of bacterial or fungal infection. My guidelines at present:
- Clean the foreskin by complete retraction over shaft and apply antiseptic liquid or cream
- Drink more liquids to prevent secondary bacterial infection
- abstinence from sex till recovery
- Control of blood sugar
- Swab of the affected skin and microbiology report in the lab with expert Pathologist
- Further course of antibiotics in accordance to susceptibility reporting
- Prophylactic anti-fungal as fluconazole or itroconazole
- Local application of Miconazole (2%) cream

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Red Rashes On The Foreskin Of Penis?

Hello, As per my surgical experience, the rashes over the foreskin of penis indicates possible balanitis through some sort of bacterial or fungal infection. My guidelines at present: - Clean the foreskin by complete retraction over shaft and apply antiseptic liquid or cream - Drink more liquids to prevent secondary bacterial infection - abstinence from sex till recovery - Control of blood sugar - Swab of the affected skin and microbiology report in the lab with expert Pathologist - Further course of antibiotics in accordance to susceptibility reporting - Prophylactic anti-fungal as fluconazole or itroconazole - Local application of Miconazole (2%) cream Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon