red patch (ulcers?) on penile glans

[GC_Going Crazy]

I am a 38-yo male who recently had a circumcision about a month-and-a-half ago to prevent what seemed like chronic balanitis. Since four months prior to the circumcision, I had a red patch on my penile glans. My foreskin was on the tighter side and was difficult to pull back or to clean all my life, so I hardly every pulled the skin all the way back in order to clean until recently. My urologist said he thought it was chronic balanitis and if I were to have a circumcision, I can avoid this issue, so I agreed to it. He also said that he would do a biopsy if the red patch still seemed to be there during the surgery. I should also mention that I was tested for seven major STDs, since I have utilized escort services as recent at early Feb of this year (but always use protection when I have).  Anyway, I tested all negative a couple months prior to my circumcision. My urologist prescribed Oxisconazole nitrate lotion 1%, which I used for about a couple months prior to the surgery. The red patch seemed to be disappearing just prior to the surgery, so my urologist did not bother with the biopsy. 1.5 weeks later, I am still in recovery from the circumcision and have been putting antibiotic ointment around the incision area and where the red patch used to be (occasionally I would also use the oxiconazole nitrate lotion), but several days ago, I notice some bubbly whiteness right in the area where the red patch used to be (top of penile glans) and by now it looks like a red ulcer with what appears to be some skin pealed around the ulceration.  So the red patch is back but this time, it looks more like an ulcer. My urologist is not available until end of the month and I would like to avoid going to the emergency if I have to. There is no pain, itchiness, or stinging, other than where the incision areas are healing. Do you have any idea of what might be going on and what I should do about it? I should also mention that I will be out of the country for a year starting next month.

[krithika]

A related discussion, IS SAGGING UPPER EYELID COMMON IN SUMMER? OR DUE TO ANY INFLAMMATION(SWELLING) OF FOREIGN PARTICLES? was started.

[GC_Going Crazy]

Here's feedback I got from another online Dr. Much more helpful.

"This seems either an allergy to the ointment or an ulceration due to the decreased blood supply caused by the surgery and sutures. Stop the antibiotic ointment as it is not needed after two weeks of surgery. Start warm compresses couple of days for twice or thrice a day. Observe it. If it gets better and start healing, continue same treatment. If not, you can try Betadine (povidone iodine) solution on it, twice a day after two days. If it aggravates, you may need to visit either ER or an urgent care clinic.
Note: definition of “warm compresses”: Take a clean towel or cloth. Dip it in soothing warm water. And apply on your penis. do it around 10 minutes, in a single sitting. Repeat it twice or thrice a day."

[Alan Rockoff, MD]

Please see a dermatologist now, rather than wait till days before you leave the country for a year.  I suspect that these changes are nothing more than post-surgical ones.  Your examining them minutely is not going to help.  I cannot imagine you will be presented with any emergencies.  Until you're seen, please leave the skin entirely alone and apply nothing at all.

Thanks.

Dr. Rockoff

[GC_Going Crazy]

Update: I just noticed that the red patch area turned whitish after washing it with anti-bacterial soap. I also feel a stinging sensation, but can't pinpoint for sure whether it is coming from that red patch area or from the incision sites. My feeling is that it is coming from the incision sites after washing, but again, not 100% sure.

[GC_Going Crazy]

Correction: I had a circumcision a week-and-a-half ago, not a month-and-a-half ago.