A bump and an itch

[willie96]

Good evening.  I am a 48 yo male in good health, although I have suffered from mild prostatitis over the last 5 years or so (no problems urinating, just soreness on some days with very occasional shooting pain that lasts about 1-2 seconds, then subsides.)

Over New Year's, I had unprotected sex with two women.  On January 15, I began to feel a sensation of pubic hair being pulled, and discovered a small painless lump with no discharge, 1/8" long at the base of the penis.  It persisted, along with the hair pulling sensation, for 2 weeks and went away.  The sensation of pulling pubic hair morphed into a mild itch that spread to around the entire base of the penis and eventually the underside of the scrotum and the left side of my penis shaft.  I sometimes feel now like a needle is just barely touching the skin, and that sensation also exists now on the inside of thigh from time to time. I could not see any visible manifestations of this anywhere, however (and still don't).  My MD thought I might have Chlamydia and on March 6, he prescribed two 500 mg tabs of Azithromycin.  I took them but the itching and hair pulling sensations persisted.  On March 17, he prescribed Avelox 400 mg to taken 1x/day for five days.  It was ineffective as to these symptoms.

It would seem that the antibiotics have killed off any bacterial diseases, and based on the lack of visual manifestations of the itching on my skin, I wonder if I don't have a fungal infection.  About ten years ago, I had a very nasty fungal infection in my groin area for which I was prescribed an oral antifungal, which cured it.  But the itching does not seem to be severe enough (so far) to be consistent with a fungal condition.  I plan to see a new doc (I relocated to a new city) for a general physical and get tested, but in the meantime, would it make sense to begin with a topical antifungal?  And would you have any other comments as well?  Any thoughts will be very much appreciated.  Thank you for your time.

[willie96]

Thanks for the feedback, it was helpful and reasssuring.  Willie96

[Edward W Hook, MD]

What you describe does not sound like a typical STD of any sort, nor a bacterial infection. I am not surprised that the azithromycin or avalox did not help.  

Several possibilities do come to mind.  One is, as you suggest a topical fungal infection.  Trying an OTC antifungal would not hurt.  Another possibilities include folliculitis.
Folliculitis occurs when the pores in your skin get plugged.  This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple.  Some of these just appear as red bumps which may or may not be  tender while others go on to actually form pimples.  In either case, they can be accompanied by swelling of nearby lymph nodes (FYI, swollen lymph nodes are a totally non-specific indicator that your body is reacting to something.  

Whatever it is, itching is often a sign of healing.  

Bottom line.  This is not an STD. It is also very unlikely to be anything to worry about.  It may be improving and the itching you note may be part of the healing process.  Once you are settled in your new location, if it is still bothering you, you may wish to be it checked out by a doctor.

Hope this helps.  EWH