locoid c potency question

Hi again Dr Rockoff,
Could I please refer you back to my earlier question & your answer on 31 Jan 03 ? (I still have the same problem & some things aren't clear to me).  I know that you said "Locoid C is far too mild to cause even temporary thinning of the skin", but did you mean by that, Locoid Lipocream 0.1% ?  Because, what I was given was  Locoid C (containing hydrocortisone 17 butyrate 1 mg per g chlorquinaldol 30mg per g).  This is a far more potent version isn't it?
According to dermnetnz.org & other articles I've read, hydrocorisone 17 butyrate is considered a class 2 potent steroid cream & 50 -100 times as potent as hydrocortisone. Maybe I have things out of context but I thought this needed to be asked.
Also 2-3 days after I stopped using Locoid I suddenly developed real pain in the head of my penis. There was no pain before. Isn't this what is known as "the rebound effect"?  Even now after over 2 months there is little sign of any real improvement. I don't dare try to masturbate or engage in sex and I have more discomfort on days when I wake up with an erection. Some nights it's difficult to sleep. The glans (glands) are highly sensitive to touch. I've read a quite a few posts here by other people & I believe through my experience (& what I've read) that my condition is similar to Robert44 who posted on saturday Aug 03, 2002, only not nearly as severe. Also I only used 1 steroid cream. (Robert, If you're reading this, could you let us know how you have progressed, hope things are a lot better).
I know that I haven't been diagnosed by any Doctor as having steroid damage, but look at Robert's case & how long it took him to be properly diagnosed if he was at all. How are Doctors/ Dermatologists/ Urologists supposed to identify steriod damage?  Is there any way to test if steroid damage has indeed occurred? Also, I don't if this is relevant or not, but I'm 34 and when I was 27 I got a bad dose of shingles in my scalp and later developed post hepetic neuralgia (which has faded away over time).  I know this sounds completely left of center but could the cream (or something else) have caused some minor form of shingles in my penis? Just thought I'd bring this up as another perhaps possible explanation. Have you ever heard of something like this happening?
Hope this post didn't seem too long-winded or militant. I just thought I should clarify more of what I've experienced in the past 2 months or so.
Thanks Dr Rockoff,
                  Nicholas.

[Alan Rockoff, MD]

The statements that "Locoid is 50-100 times more potent than hydrocortisone" and "Locoid is too weak to permanently damage the skin" are not mutually inconsistent.  Locoid is stronger than the very weak hydrocrtisone, but still too weak to permanenetly damage the skin.  I have never seen it even temporarliy damage the skin.  And yes, that is true of Lipocream as well.

No test is needed to diagnose damage: the skin looks thin and veined and whitish.  Any dermatologist can diagnose atrophy (skin thinning) by looking.  Even when present, thinning is reversible with cessation of whatever caused it.

There is no connection with shingles (a recurrence of checkenpox in one nerve region) and symtpoms elsewhere at another time.

Finally, skin thinning, even if present, would not explain your symptoms.  I say this with humility and trepidation, but it seems to me your symptoms have a massive psychological overlay.  They simply are incompatible with any penile disease I have seen or know of.

I suggest you at least consider thinking of your problem in this framework, and look into evaluation and treatment accordingly.

Best.

Dr. Rockoff

[nicholas]

Dr Rockoff,
            Thanks for your reply. I'm glad to hear that the Locoid couldn't have possibly done any damage and I can see now that my question about identifying skin damage was silly.  I fully admit that since the shingles I've become a bit of a hypochondriac. I think I might get another swob taken from my Doctor. If everything is clear then I will seriously consider taking your advice.
Thanks again, Nicholas.