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Dermatology  (Expert Forum)
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Red Shiney Scaley skin on penis, somewhat painful
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
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MedHelp Member's Question

Red Shiney Scaley skin on penis, somewhat painful

by silverbeach, Jul 11, 2003 12:00AM
About three months ago I had unprotected sex with my girlfriend.  About 9 days later I thought I noticed a sensation in my penis so i went to get tested for STD's.  Within another week i developed urethritis.  Soon after that the skin on the head of my penis became irritated.  I noticed recurring reddness in the same area with scaley, shiney areas measuring 1-2 mm.  The areas at times would became very red and almost painful.  I took 1 week doxycline, 2 days Zithromax and 1 month levaquin.  I also took 10 days Valtrex.  I then took 5 days of an antifungal medicine.  These meds were giving to me over a course of three months and I did not see any imrovements with the mentioned meds except after taking Zithromax my urethritis went away.

All of my std tests cmae back negative.  My girlfriends all came back negative.  We both got tested for HSV and my HSV 1 test was positive, HSV 2 negative (took specific test)  Both negative for her.  The areas do became somewhat painfull and burn and then several hours later are almost gone again. Sweating, sex and alcohol seem to make symptoms worse.  the problem is my urologist thinks it doesnt look like herpes but is acting like it.  And my dermatolgist says it isn't herpes, that it doesnt appear herpetic at all, but rather a psoriasis.  I am confused.  For some time i used several different creams including triamincoline, nystatin with triamincoline, monostat, vaseline, and vitmain E.  I have now stopped taking all meds and will not put anything on it.  

Could I have psoriasis or some other dermatitis?  How about a allergic rxn to meds or lichen?

Thanks for your help.

Doctor's Answer

by Alan Rockoff, MD, Jul 13, 2003 12:00AM
Your dermatologist sounds much more compelling to me than your urologist.  What you describe sounds nothing like herpes.  This at most is some sensitivity of the skin itself, not a fungus or infection of any type.  I think your instincts are correct to stop everything.  I suggest washing with Cetaphil cleanser and using Cetaaphil moisturizer (both OTC), and doing nothing else.  The situation should take care of itself.  Enough doctors and tests.



If you have further problems, please stay in touch with your dermatologist, who seems to know what he's up to.



Best.



Dr. Rockoff
Member Comments (8)

by silverbeach, Jul 12, 2003 12:00AM
To update you on the ever changing condition.  First to clarify, the 1-2mm patches on my skin are in groups, usually in the same spot.  Iyt has been getting larger and can cover nearly 1/3 the top of my glans.  It appears that I can see each skin cell, each is slighty raised and irritated.  Throughout a day like today, I first woke up and the area did not appear red like the day before, not completely gone though.  After peeing, showering and getting to my job site were i was sweating all day it began hurting and even burning.  At times they looked redder than other times.  When they looked red, they hurt more.  Rinsing my penis with cool water was the best relief.

Since this has been happening three months ago, I can say it has never gone away completely.  The areas do not open into sores and if I look i can usually see the outline of the area.  It appears to be getting worse and covering more of the glans.

I do have a bump inside my urthra opening that appears to get swollen like the rest of the skin.  Inside the tip of my penis feels the same way.  Most likely within an hour or two, the redness will be nearly gone ands it wont feel sore.  

On a day like today i was soaked with sweat all day, i also noticed my sweat has a funny odor, almost like mildew??



Hope this all helps!!!



Thanks for your help.

by silverbeach, Jul 14, 2003 12:00AM
To: Dr. Rockoff
I really appreciate your reply and although I have had mixxed responses fromn my doctors I agree with you and my present dermatologist.  Problem is the past two days the area has all become very red.  unlike before when the redness has gone away daily, it is now bright red.  The pain and burning are not unbearable but does alot to interfere with my day.



I have used the lotion and soap you recommended.  how long can I expect this to continue and is it time to see my doc again??

I should add that occasionally i feel a tingling sensation and maybe thats why my uroligiust thought herpes.



Thanks again!!!!

by Alan Rockoff, MD, Jul 14, 2003 12:00AM
If you're that uncomfortable, then perhaps it is time to see your doctor again.  But it still isn't herpes.



Dr. Rockoff

by silverbeach, Jul 16, 2003 12:00AM
To: Dr Rockoff
Dr. Rockoff, (no reply needed)

You are amazing..thanks for taking the time to look back and see i was still concerned.  The past three months have been very difficult.  Its funny and sad, that during this time I was convinced i had caught herpes.  This was only because of my urologists input, based on what he thought.  Scarey thing is I did alot of research during this time and learned that many people are told they have herpes, go through denial, accept it, then meet someone with herpes (because they want to do the right thing), and then actually catch the virus.  I met a girl like this, and thanks to you and her, (she told me of her story) this wont happen to me.  

My skin has since cleared up dramatically, without my Dr's prescription of valtrex!!!!  And I only have some minor irritation as the day progresses in the end of my urethra, which i feel is irritation.  The tingling seems to come and go the more I examine my meatus and urinate...hmm..did I self induse this??

I do have an appointment with my urologist in two weeks, I will continue with the Cetaphil lotion and look forward to telling him about my miracle herpes treatment. Cetaphil lotion.  

Thanks for your time and compassion.



by Alan Rockoff, MD, Jul 16, 2003 12:00AM
Thanks for the update.  Good luck.  ASR

by silverbeach, Aug 16, 2003 12:00AM
To: Dr. Rockoff
i'm not sure if you'll look this far down the page but if so here is an update.



my condition persists.  The tip of my penis contniues to go through cycles of mild pain, tingling followed by redness (the redness has been chronic).  The area is typically in the same spot.  Thier are two bumps insde the opening that come and go.  On some mornings my right testicle is swollen.  Their has been no open sores that crust over but the area  has gotten quite red and irritated at times.



My dermatolgist has examined it several times and although he does not feel it is herpes he says it may be, he prescribed an ointment called zovirax, which although has not healed the area seems to start to help then symptoms seem to continue?

Any other ointment only makes burning redness worse.



I decided to pursue this further with a infectious disease doctor, after two weeks of waiting I've been reasured I dont have any major disease.  However, upon looking at several of my HSV blood tests here is what we have.



1 month after onset of symptoms.

HSV 1/2 IGG =  29  Pockit test negative  IGM= negative



4 months after:



HSv 1/2 IGG= 20   Type II specific negative  IGM= negative



Girl tested positive for HSV 1/2 IGG = 3  Type 2 neg



I recently took another test Type I and Type II specific awaiting results.



The infectious disease specialist says he is concerned about the high reading followed by a decrease and we will look at my present levels.  He is not convinced it is herpes yet.



i have taking valtrex for 4 weeks, 500 mg daily no relief.

He does say herpes can present itself atypically and sometimes valtrex does not work.



He also feels Rieters may be a concern so he did blood work for that.  I do have low back pain, but have had it before this although now it is persistent, aslo my ankles and wrists are sore after not using them typically in the morning.  Injuries to these arreas seem to take forever to heal. Although most of what i have read regarding penis problems and rieters say the sores are painless, mine can be painfull.



This condition obviously causes me concern because it has been nearly five months now.  I know I had been exposed to herpes 1 many years ago and am wondering that if it is some atypical presentation why would it be so chronic after my body had already had antibodies for atleast 12 years.



If you still feel it is not then what could it be??



I do have mild burning from day to day inside my urethra, and after working and sweating for several hours the tip can swell slightly.



Not knowing exactly what it is has been the biggest cause of stress for me.



After this update what do you think??









by Alan Rockoff, MD, Aug 19, 2003 12:00AM
Your post is bewildering.  I think you are suffering from an excess of doctoring, among other things.  I continue to feel that you are best ignoring the symptoms and getting on with your life.



Dr. Rockoff

by countryboy79, Apr 10, 2008 12:16AM
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