Rash & Irritation in Genitals

[TinyTim35]

I have had a rash on my penis for over 5 weeks now. I had an STD test two weeks ago that came back negative. The doctor recommended that I see a dermatologist, but I simply have not had the time to do so and frankly thought the symptoms would be gone by now.
The rash started with some red skin irritation in the left inner foreskin. After a couple of weeks it moved from the rim to the head and the appearance changed to tiny red spots on the head and around the rim. A couple of weeks later it disappeared from the left side but moved to the right side. Now it's all over the inner foreskin and there is redness at the head. It does itch once in awhile but not constantly. There is no pain during urination, though sometimes during the day I do feel some discharge. Not too much though and its clear. I did use some hydrocortizone for a week and it seemed to have improved but I'm not too sure.
Obviously going to the doctor would give me a better diagnosis, but I can't make an appointment for a couple of weeks. Based on the description, what could be the condition? How should I treat it?
It is worth noting that I am uncircumsized and some literature that I have read suggests not washing the foreskin with soap? What is the best course of action?

[Bhupinder Kaur, MD]

Hello,
Yes the redness on tongue can be due to oral yeast infection. As advised earlier you can get a KOH examination and fungal culture of the skin scrapings done to confirm the diagnosis and once it comes out yeast infection, then you can start with the topical antifungal treatment.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[TinyTim35]

I finally got a chance to go to the dermatologist & he diagnosed me with a yeast infection with the naked eye. I'm not too convinced of this diagnosis as & he wasn't really interested in hearing out all my symptoms, but I was prescribed econazole nitrate & I have been applying it for 3 days & the condition does not seem to be improving. I was advised to apply the cream for two weeks.
I have another symptom now, this morning while brushing my teeth I noticed some discomfort in the back of my tongue. I took a look and I had red raised bumps in the back of my tongue & I experienced some minor pain while swallowing when eating breakfast. Could this be oral thrush? could I have two yeast infections in two separate body parts? Is this cause for concern?

[Bhupinder Kaur, MD]

Hello,
Your symptoms are suggestive of balanoposthitis. It may have any of multiple bacterial or fungal origins or be caused by contact dermatitides. Examination of the glans and the prepuce often reveals a red, moist macular lesion. KOH slide preparation and biopsy of the lesion are needed to confirm the diagnosis.

One of the important causes is Diabetes mellitus. The use of the latex condoms can also lead to the same. Thus, will suggest you to get your blood sugar checked, maintain a good hygiene of the region by cleaning the sub-preputial area, rule out a fungal infection (candidiasis).

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.