6 month rash on scrotum

[uptownnotown]

I recived felatio & hand job w/ a condom. saliva dripped to the base of my penis (ie were the condom wasn't)   couple days later I felt a mild itch on my testes & small bumps on the shaft of my penis .  The bumps weren't discolored & were very small.  About a month later my testes were itching a bit more & the bumps on my penis were the same.  I felt some discomfort around the bumps (like pins & needles) that I hadn't felt before.

Pcp doctor told me I had jock itch .  I used every imaginable jock itch cream/powder over the next 2 months.  Nothing worked.  They even had me on an anti-fungal pill as well.

Rash spread over my testes and penis .  Everything eventually turned red.  Veins were showing up close to the skin that hadn't been there before.  Big & small.  Everything started burning.  No scaling, flaking, or oozing.  no blisters.  rash spread to creases in leg. Developed what appears to be folliculitus (folliculitis) in pubic hair area above penis.

Seen Dermo 2x.

Told me I'm just irritated & gave me densonide.  It didn't help or hurt.  

Been back to pcp doctor and he's put me on anti-biotics which haven't helped either.  Been back to the dermatologist after the rash moved between my legs & he still said that nothing was wrong & gave me hydrocorozone 2%, but that burnt when I put it on, so i never used it.

It's now been 6 months all totalled.  With the last 3 months being the worst with the burning.  Somedays the burning is worse than others.
  
Concered from day 1 that this was an STD , since it happened right after sex.  I haven't had any blisters or discharge and my doctors all scoff at the idea that it's an STD .  

I've abstained from putting anything on it this past month,  hasn't helped either.  

Everything is red, but there is a more distinct redness on my testes.
It's about the size of a dime & it shows up in different places.  It's extremely painful.

could this be some atypical herpes or red scrotum syndrome?  Or somthing else?

[Edward W Hook, MD]

I have some comments and thoughts and hope they will help you.  As I start however, let me say that as I read through your post, each time I thought I had a sense of what was going on, the next line informed me that your PCP and dermatologist had suggested the same thing with little benefit.  My comments will start with your initial concern and then move forward.  I hope they help.

Let's start with your initial exposure.  Intact skin is very resistant to infection and no one has ever gotten an STD from spit, thus while you were concerned, I can assure you that the saliva which dripped onto your penis did not carry STD.

If that's true, then what about the bumps and itch?  We find that following concerning exposures such as yours, many patients tend to examine themselves more closely than they had in the past, noticing previously noticed imperfections such as bumps, ridges and fissures.  Having noted this, they find themselves wondering if they "feel" OK in that area and again, the focused attention leads to sensations which almost always are itching or burning in the area.  Scratching, interestingly enough, rarely relieves these irritations and actually is well known to make the itching and burning worse.  My guess is that this is what is going on here.  You have been examined by your PCP and a dermatologist, both of whom are likely to have viewed far more genital lesions, bumps, etc than you.  

How would I approach it now?  I would go back to the 2% hydro-cortisone, using it two or three times daily and particularly just before bedtime when the itching tends to be worse.  The HC is anti inflammatory and will reduce the itch.  The initial burning you experienced the first time you tried it is likely related to the irritation already there.  In addition, at bedtime, taking a benadryl (available over the counter) will further reduce the itch.

My guess is that if you can control the itch and the urge to scratch the involved area, the problem will go away.

I hope this is helpful.  EWH

[uptownnotown]

Thank you.  I guess I failed to mention that the itch went away about 5 months ago.  Now it's just burning.  given that's the case would the hydro cortisone reduce the burning?

I've never scratched it.  

One of my questions was unanswered:  could this be some Atypical  herpes or red scrotum syndrome?  Or somthing else?

and what can i do to stop the burning?  

thanks

[uptownnotown]

Thank you.  I guess I failed to mention that the itch went away about 5 months ago.  Now it's just burning.  given that's the case would the hydro cortisone reduce the burning?

I've never scratched it.  

One of my questions was unanswered:  could this be some Atypical  herpes or red scrotum syndrome?  Or somthing else?

and what can i do to stop the burning?  

thanks

[Edward W Hook, MD]

The sensations you describe are not suggestive herpes or other STD in any way.  

I would still give the hydrocortisone a try.  In addition, sometimes taking an oatmeal bath often helps to sooth irritated skin.  You can by the oatmeal for baths at a pharmacy.  One brand name is Aveeno.

If these fail, I would then work through it again with the dermatologist.

Good luck.  EWH

[uptownnotown]

A related discussion, any suggestions are welcome was started.