irritation on Penis 4 months

[grand1687]

I have had an irritation on the right side of my penis just under the glans since late October.  At first it was just very mild and I showed it to my dermatologist and he said to not worry about it and to leave it be.  It was bothering a little when I worked a lot so I put some vaseline on it to protect it and Cortaid spray.  Within a week it was worse and I went to see the PA at the dermatologists office. He thought it was a non-specific irritation and told me to use cutivate. After 5 days it was no better and we switched to Balmex.  After a few more days it was still not better and actually worse.  The PA did a skin scraping and found yeast present and prescribed Econazole.  That helped, but the irritation did not fully go away.  I saw my Urologist and he felt that the pattern could fit a yeast infection where it was and switched me to a Nystatin/triamcinolone ointment. After 3 days it seemed a little more red and my derm put me on straight Nystatin with no success. Since then I have been on Biafine, Clobex, and Elidel with little help.  A second Dermatologist told me it was mild when I was on the Biafine and told me to try stopping. When I was off all meds, it did seem to get better, but has not fully gone away.  We then tried the Clobex and then Elidel with no success.  It had slowly been less bothering but last week started to bother me more again.  It is now 4 months and it is still present. I was also on a 7 day course of Valtrex for Shingles in December and this did not seem to help it.  My Derm PA does not think it is infectious since it is lasting so long and has never been tremendously better or worse with treatment.  I was worried about herpes at first but I have never had any classic lesions and 3 years ago I tested negative and have been with one partner since with no problems till this in the 3 years. My Derm PA is now suggesting a biopsy.  What could this be?  Is it still possible this is infectious or just an inflammation. Thanks for your help.

[grand1687]

Thank you for the response.  I have been thinking that is what I should do, but just have been hesitant because it still has a mild/moderate burn feeling to it when it rubs clothing.  When it first started it was really bothersome all day. Now if I am busy doing something else and my mind is completely off it, it does not bother much but mildly.  Is it possible for the sensation to last this long. If it was just the redness, I would not worry at all. Thanks Dr. Rockoff.

[Alan Rockoff, MD]

Most likely you have leftover pinkness from former irritation.  Any yeast that may once have been there is certainly dead.  At this point I think any active treatment you do will perpetuate the problem, not resolve it.  Herpes is out of the question.  May I suggest that you have seen enough doctors about this already for the moment, and that you leave the skin alone for a month and do nothing?  I don't think you have anything to lose, and it's quite likely that this will allow the skin to get completely better.

Thanks.

Dr. Rockoff