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Dr. Nair or DermDoc preferred please* For about 1.5 years…

Dr. Nair or DermDoc preferred...
Dr. Nair or DermDoc preferred please*Hi,For about 1.5 years I've been dealing with a persistent discoloration, dryness, and bumpiness of my penis glans that has been resistant to regular treatment of fungal infection & balanitis in general.This was triggered after I was treated for what was diagnosed as folliculitis of the pubic area, either a fungal or bacterial infection that spread around my pubic area but resolved after 6-7 weeks. This was diagnosed by a dermatologist but never confirmed. The infection appeared days after Protected sex with a new partner.The visible finally infection cleared from my pubic area. But immediately after I developed the symptoms on my penis glans, seemingly out of no where -- severely, scaly, angry red, shiny -- basically all the symptoms of balanitis. I was prescribed a cortisone/clotrimazole mix which seemed to have no effect and I stopped after 2-3 weeks application as I was concerned about skin thinning due to the cortisone.After 2 weeks the symptoms subsided and became less severe but the skin has never returned to normal. My glans used look flesh coloured and healthy, and now looks permanently dried out, darker and discoloured and covered in small red bumps I take to be visible capillaries (see photos). It is especially aggravated and noticeable when erect. It is not painful... maybe a tad itchy with a general light feeling of irritation. I am at a loss and the dermatologist I went to a year ago wasn't much help beyond prescribing the cortisone/clotrimazole which didn't work.I've been urine tested for infection twice which came back negative. I've just been self-treating, randomly going back and forth between Avene Cicalfate and coconut oil, twice a day which helps with the dryness but not much else. Some days look worse than others, fluctuating from moderate to worse. Sometimes it looks like things are getting better but it always regresses. Again, it's been over a year with this problem and it is seriously affecting my sexual confidence. I would really like to resolve this.Thank you for reading and I really appreciate the help in advance.
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Customer reply replied 7 months ago
photos added
Answered in 2 hours by:
1/16/2018
Dr. Pravin
Dr. Pravin, Dermatologist
Category: Dermatology
Satisfied Customers: 2,979
Experience: Senior Consultant MBBS DNB (DVD)
Verified

Hello

Welcome and Thank you for your query posted.

My name is***** and being a Skin, Hair and Nail specialist I would be able to provide you with an appropriate solution to your concern.

Please note that my Goal is to provide you with an Excellent Service .

Before I answer your question I would like to get some more information:

Would you like me to answer your query ?

Please note that the answer provided is for information purpose only and does not substitute a Doctor - Patient Consultation in Clinic

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Customer reply replied 7 months ago
Sure thank you

Thank you for your reply.

Do you have a history of Diabetes?

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Customer reply replied 7 months ago
No. I had a physical not too long ago and my blood sugar was normal, as far as I recall. It was more than a year ago though.

Thank you for your reply.

This does not sound like an infection problem. All your tests are negative .

This can be defined as Lichen Planus of the glans penis which is an inflammatory process of the glans penis and associated with darkness and discoloration of the penis glans.

The best way to deal with your problem is to apply 3 months of Tacrolimus ointment on the area to reduce your discoloration and underlying inflammation.

Use of cortisone , clotrimazole , cicalfate , aveeno may not help for the present condition . That can be continued for the dryness over the affected area.

Please do let me know if you have any further queries.

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Customer reply replied 7 months ago
Hi Dr. Pravin -- thanks very much for the reply.Can I ask how confident you are in this assessment? (I.e. are my photos consistent with others you've successfully treated for LP?) Can LP be triggered & progress in the same fashion I've described, and remain in relatively the same condition for so long?Not that I think you're wrong, I'm just trying to get more info on this possibility.Thank you again for your time.

Thank you for your reply.

The signs on the glans of darkish discoloration with history of the area becoming dry all the time makes my confidence of the diagnosis or assessment very significant

Yes , LP can remain for a long time .

Yes I am definitely sure about this.

Please do let me know if you have any further queries.

Dr. Pravin
Dr. Pravin, Dermatologist
Category: Dermatology
Satisfied Customers: 2,979
Experience: Senior Consultant MBBS DNB (DVD)
Verified
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Customer reply replied 7 months ago
Great thanks Dr. Pravin. I appreciate the insight.
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