Rash (penis) + headache

[Sentenza]

Here is my situation.

I've been having these rash on my penis (mostly around the base of the gland and inside the foreskin) for a long time.  I'd say well over 10 years.  I am 29 years old, and I started noticing them when I got sexually active.  I've been with the same partner for 12 years and we are having unprotected sex.  

The rash seems to be starting off as small red dots. It seems to progress for a couple of days, going from red dots to having some skin peeling nearby and the small red dots seem to get bigger and more important, before eventually (3-7 days later) disappearing completely.

I've seen a GP (I know) a couple of years ago about that problem, and he gave me some Clotrimaderm cream (anti-fungal I believe).  Although it does seem to help a little because the rash may seem to go away faster, it does always come back.

I've considered it could be irritation, as it seems to be triggered shortly after intercourse.  Although something as been bugging me:

I can usually tell when I have one of these rash, because I'll be getting bad headache.  And by bad, I mean migraine-like where 500-1000mg of acetaminophen can barely help.

I don't know where to turn...  Should I be getting a different cream?  Suspecting a STD?  Is it safe to have intercourse with my partner while a rash is present?

Thank you for your time and presence online.

-Sentenza

[BhumikaMD]

Hi,

It was wise of you to cosnult a skin specialist for the symptoms you are having. Nothing can be siad with absolute surety without a clinical examination.

Let the test reports come in and then decide on the final diagnosis. Till then all the above remain a possible differential.

Have you tried calamine lotion, anti histamine medications, etc? Have they helped? It could be psoriasis too - but that your dermatologist would have confirmed after a clinical examination.

Let us know about the reports when they come in. Post us if you need any other information.

Regards.

[Sentenza]

One more thing I forgot to mention that might prove to be relevant:

I have history of Psoriasis myself and both of my parents.   I get psoriasis on my scalp.  I've been reading a bit about genital psoriasis and can't exclude the possibility.

I'm waiting on your reply/opinion.  

Thank you for your presence online.

[Sentenza]

Thank you so much for taking the time to reply!

I am known to have occasional flares of eczema, mostly on my fingers or under my eyes.  

Could there be any correlation between eczema and the headaches I tend to get when it flares up?  I've been told that headaches and penis rash are often signs of HSV-2, it it worries me a little, although both I and my wife do not get any types of sores on either mouth or genitals.

I went to see a dermatologist yesterday (I work in a hospital) and they took a culture of the skin residues, which he believed were smegma.  He also didn't rule out Herpes, for which he told me to come back for a culture the day it starts to spot.

Any opinions/advice?

Thanks again!

[BhumikaMD]

Hi,

It could be eczema, sweat dermatitis, allergic reactions or eczema.

You need to wash the areas several times with fresh water. Do not use any cosmetic products at the sites.

Apply calamine lotion at the site of the lesions and see if it helps. You could take some oral antihistamine medications like cetrizine or loratadine. You need to maintain a good personal hygiene .

Anti-itch drugs, often antihistamine, may reduce the itch during a flare up of eczema, and the reduced scratching in turn reduces damage and irritation to the skin.

For mild-moderate eczema a weak steroid may be used (e.g. hydrocortisone or desonide), whilst more severe cases require a higher-potency steroid (e.g. clobetasol propionate, fluocinonide).

Eczema can be exacerbated by dryness of the skin. Moisturizing is one of the most important self-care treatments for sufferers of eczema. Keeping the affected area moistened can promote skin healing and relief of symptoms.

http://en.wikipedia.org/wiki/Eczema

Maintain good personal hygiene and wear lose comfortable clothes preferably cotton.

It would be advisable to consult a skin specialist for your symptoms and a proper clinical examination.

Let us know if you need any other information and post us on how you are doing.

Regards.