Doctors Please Answer!

[buckeye2010]

Shortly after using Lotrisone on skin at my penis opening(meatus) as directed by a urologist I developed irriation and redness, which later seemed to become a purple-ish discolorment with a very small papule also. I used the L-O-T-R-I-S-O-N-E which is a strong or potent steroid cream and anti-fungal combination ointment for 5 days (2x a day) before I noticed this. Anyways, I went to another urologist and he said it looked "normal" and acted as though I needed no further treatment and said it would go away. So I let it go for several months and just used various mosturizing creams, vasoline, aquaphor, etc. for about 9 months with very minimal improvement. It seems as though the skin is still loose right at the opening and gets easily and often dis-aligned, and it still also has a purple discolorment to the skin yet the original papule has decreased some. So I finally went to a dermatologist who thinks it is dermatitis and that five days of a potent steroid cream wouldn't have caused atrophy. So I am currently using EpiCeram (skin barrier cream) along with Man 1 Man Oil (penis health cream) and Emu Oil to assist with healing and thickening of the skin. I still question whether atrophy has occured though; since I did use the Lotrisone very liberally, in the sense that when I applied it I put plenty on(more than sparingly) and didn't really rub it it that much to avoid getting it down in my urethra. I am still not convinced that it is dermatitis and am worried that I have permanent atrophy of my meatus skin by appying to much Lotrisone at a time! I want to know what a doctor on here thinks as to whether there is any possibility that it is atrophied skin that I am dealing with, and if so, is there a treatment now? Also, if it really is dermatitis, then is there chance that it has caused permanent effects on my skin since I left it untreated for so long(about 9-10 months)? Are there complications like this to untreated dematitis or even atrophy!?

[buckeye2010]

Okay, the dermatologist I saw said it is DERMATITIS and I know I can use EPICERAM! That does NOT answer the questions I asked at all! I want to know if dermatitis left untreated for a peroid of 9 months or so could cause any permanent effects to the skin or doesn't it matter when it is first treated? Also, is it possible that what I'm dealing with is actually steroid induced atrophy since I used LOTRISONE liberally on my meatal skin for 5 days (2x daily) and right after that is when it all began, and what can be done about that!?

[Bhupinder Kaur, MD]

Hello,
As I have replied earlier, you can use epiceram on the meatal skin. Also lichen planus needs to be ruled out. Lichen planus is an inflammatory disease that affects the skin and the oral mucosa, and presents itself in the form of papules(flat spots) or rashes.Treatment is available only on prescription and consists mainly of steroids,retinoids,hydroquinone and phototherapy.

It is an itchy papular eruption characterized by its violaceous color.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.