Penile Skin discoloration/Urinary Pain (non-STD)

Dear Dr.,

I am a 26-year-old school teacher, from Northeast Ohio. I was circumcised at the appropriate time after birth. While growing up I experienced repeated penile skin reactions to various chemicals I used while showering, masterbating (masturbating), and during sexual contact. The skin would always get extremely irritated, then flake off and heal. However, after one such episode the skin remained thin and slightly red, also dark greyish erosions appeared and have stayed to some degree for approx. the past five years. Also, I have constant pain (to various degrees) during urination, and pain in my groin and right testicle (most likely from sports and body misalignment). Also, during bowel movements I will often experience discharge from the penis (clear/white) after which the urinary pain briefly subsides. I have had a general examination from several Drs. over the years who have said that it is not penile cancer, I have had a urethral swab for STD's which came back negative, I have had a clean-catch urinalysis at both a hospital and my urologists office which was cleared, and my urologist said it was most likely dermatitis (which I don't believe would be associated with the urinary symptoms). I have been extremely worried about having penile/urological cancer over the past 8 months or so (after a friend contracted lymphoma), and have become so worried that I began having anxiety/panic problems and am now taking 40 mg. Citalopram(Celexa) and a small dose of Lorazepam(Ativan). Years ago a dermatologist gave me hydracortisone but I was worried it would be too harsh, I am currently treating with Vasoline Pet. Jelly after each shower, and using PH balanced non-allergenic body wash. Also, my urologist said my prostate was somewhat swollen and my Dr. suspected inflammation. Are there any dermatological/urological treatments you recommend for discussion with my G.P.? I have had 7 sexual partners but again the urethral swab came back negative. Thanks.

[Alan Rockoff, MD]

To be honest, I'm not sure why you're even thinking about penile cancer.  Circumcised men don't get it, and none of your symptoms sounds remotely related to it.  It sounds to me as though you have at most mild irritation plus a lot of anxiety.  Perhaps you want to show the penile skin to a dermatologist once more (hydrocortisone is not harsh, by the way, if you use the right one.)  I think at this point that you need counseling more than you need medical attention to the penis and associated structures.  You seem to be paying too much attention to them now as it is.

Good luck.

Dr. Rockoff

[ABCDEF44415]

Thanks for your advice and I agree, what is the right kind of Hydrocortisone? And how should it be applied? Thanks.