Redness at the tip of penis

[Curiousinportland]

I am a 43 year old male and have been experiencing problems for the past several weeks.  It all started about 6 weeks ago when I had a weekend where I think that I drank beer and coffee for the most part.  I woke up on Sunday and was very dehydrated and had an itchy rash on my arms but I had a rash/redness around the the opening of my urethrea.  I thought this may be a result of my dehydration but after some extensive hydration they both remained.  

I started applying hydrocortizone to my arm and the rash went away.  The redness at the tip of my penis remained.  I went into a doctor and he looked at it and though that it was some sort of an allergy.  I have had a couple urinary tract infections/urethritis in the past and informe him of that.  He prescribed 7 days of Macrobid.  I was not comfortable with this because I had just relocated and so I called my primary care physician that I had seen for years and he prescribed 10 days of doxycycline.  I ran the course of the prescription and the redness is still there.  There is no discomfort during urination, discharge or bumps/sores.  It is also not ichy.  This doctor took a urine sample and said it came back clean and no evidence of infection.

The rash on my arms returned a few days later so I went to an urgent care facility because I was traveling.  The doctor looked at both my penis and arm and came to the conclusion that it was probably yeast because of the antibiotics that I had taken and prescribed over the counter lotramine for both and a steriod cream for my arm.  After about 10 days of that the rash on my arm went away but the redness on my penis remained.  Once again a urine sample came back clean and free of infection.

I went to another clinic once I returned home and the doctor once again thought it was yeast so she prescibed Fluconazole and a prescription steriod/antifungal cream.  The pill seemed to do the trick but the cream seemed to irritate more than help.  She also took a urine sample that came back clean and no evidence of infection.  She did mention something about genital herpes but when I told her how long it had been going on she dismissed that due to the duration and the lack of blisters/leisons.

Finally, I when to a local urologist to have this checked out as well as some urination issues that I had been having.  He looked at it and ruled out yeast and urethritis but checked my prostate and found that I might have a slight case of prostetitis (sp).   He prescribed a month of Bactrum and Clobetasol cream for the redness.  He asked about sexual exposure which I explained that I was sexually active and practiced safe sex.  

I am just wondering what could be causing the redness at the tip of my penis.  If I had contracted either chlamydia or gonorrhea would my urine sample still show clean from infections?  I know that specific tests are used to identify those bacteria.  Also could the prostatitis be causing this redness?

I am just looking for direction here.  If it is an STI I would like to get it addressed...I think that the 4 doctors I saw dismissed that because of the absence of urinary bacteria, discharge and no burning/painful urination.

I would appreciate any feedback you can give me.

[Kevin Pho, MD]

It seems you have been treated for multiple possibilities.

Dermatitis, yeast and STDs all should be considered - and it seems to have been treated appropriately.  

Repeat urethral swab and urine tests can exclude STDs.  Prostatitis can be considered, and evaluated with a transrectall ultrasound.

I agree with the trials of steroid creams and antifungals.  A referral to a dermatologist can be done for further evaluation.

A urologist can be consulted.  Prostatitis can be evaluated with the ultrasound as well as a prostatic massage.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Curiousinportland]

Thank you for the input.  I appreciate.

I guess the only question that I have is whether or not 4 clean urine samples would indicate that I am free of bacterial STD's or do I need to have case specific tests done.  I have been told that a regular urine sample would show positive for chlamydia or gonorrhea bacteria but would require specialized tests.  Is this true or is this bacterium only detectable through specialized tests?

[Curiousinportland]

The reason that I posted on this forum is because I posted the same question on the STD forum and the Dr. there said that I could more than likely rule out STD's because redness on the tip of the penis is not a stand alone symptom but if there were pain or discharge I would have to consider STD's.  He stated that I could rule out chlamydia and gonorrhea.

I came here to see if there were other urological reasons for this redness.