Balanitis or something else

[irritated2]

I am a 45 year old, un-circumcised male, married 18 years, never engaged in any risky sexual behavior.  Over the last 5 years I began having recurring bouts of what appears to be a form of Balanitis, Diabetes tests negative, Herpes tests negative, bacterial cultures negative, yeast cultures barely anything.  I cannot figure this out, it gets very painful, head of penis covered in small white ulcer type lesions, recessed, not blisters.  Noticeable offensive odor, I have tried Clotrimazole, courses of Diflucan, Nystatin powder, etc...  None of the Antifungals seem to help.  My GP put me on Acyclovir, he said in case it is viral Herpes, for which I said I tested negative.  This is very frustrating.  I posted a picture under the name irritated2 which gives a very good look at it.  Seems the worst as far as pain is right behind glans at rear most section of penis. Where the foreskin bunches up when retracted.  When it is at worst, I cannot even retract it.  Seems strange it began happening 5 years ago and never before.  And I never really spent much time on extra hygiene all those years, but now everyone is telling me I need to wash it like it's a BMW or something.  I don't get it, please help, as it seems to take over a month to clear up, and this time it is worse than ever before.  Thank you.

[Stephen Liroff, MD]

Since all the standard diagnoses are not being substantiated, I wonder if this is an allergic reaction, either to a substance that comes into direct contact with your penis (soap, cologne, condom, douche chemical, spermacide) or to some medicine that you  take intermittently that results in this reaction. This last is called a fixed drug eruption. I think that you should see dermatologist  when you are in the midst of one of your outbreaks. You may need to have a skin biopsy to get the answer.
Good luck!
S.A.Liroff, M.D.