Redness around penis corona....tysonitis? STD? rash?

[JohnT333]

I am a 30 yr old sexually active man, and I have been very worried about a condition I have been experiencing this for about 3 months
I noticed it was itching slightly and feeling generally strange at the head of penis but the kind of transient itch or burn that when you touched it the feeling go away.
After a week I went to clinic to get STD test.  The doctor told me it looked fine, just irritated around the penis corona.  I was prescribed clortrimazol to help.  The STD blood test came back negative including the Herpes (HSV-1 and HSV-2 specific).
I noticed that the rim of the corona became slightly raised and wrinkly in a strip around the rim.  The doctor told me it may be tysonitis.
After having this condition for about a month I noticed a tiny skin colored bump near the urethra, size of about 1-3 mm, then a few days later a similar kind of patch on the other side of urethra.
The same doctor gave a light abrasion cotton swab and a light abrasion alginate swab and more blood work.  The test results were all negative and the culture showed no virus.    He saw the little patches and told me that it was likely innocuous and self-limiting. He suggested I continue the lotramin around corona, keep the area clean, and a little bacitracin at the frenulum which is a little red. The redness around the corona leaves me with a dull irritation/itch, but any real itching comes from skin on the shaft like jock itch, and I have had jock itch 10 times since adolescence.
The red around the corona is like capillaries, and they kinda reach into the glans of penis on the sides.  I am circumcised but still have enough foreskin that it covers the area in question when at rest.  My doctor told me it didn't look like candida or any real balanitis. Today I noted another small bump ~1 mm on the rim of corona
Additionally I have been very stressed by working long days, and not eating the healthiest food.  I have gained 10 lbs (from 155 up to 165 lbs) in 3 months which is abnormal for me.

[Edward W Hook, MD]

1.  It is time to stop the lotramin.  If it hasn't made any difference by now it will not.  There is little downside to a brief (5-7 days) trial of OTC hydrocortisone which can be purchased at most drug stores.  If it doesn't make a difference either, this makes it less likely that this is a pathological process.

2.  Sorry I have little experience with tysonitis.

That you've had prior dermatological issues makes it more likely that this is what this is.  EWH

[Edward W Hook, MD]

Welcome to our Forum. I have read your earlier, more detailed note on the STD Prevention Community and agree with the advice provided by Grace.  I would also add that your doctor does sound very informed and thoughtful. The evaluation and course of action is probably quite similar to what I might have done if I had been seeing you myself.  

What you describe, even without the test results you describe does not sound like an STD.  There are many benign conditions which involve the genitals and much person to person variation.  As people become worried they tend to examine themselves to a degree that they had not in the past, then notice the normal variations I mentioned above and start to worry.  You may have had a fungal infection or other benign, non-STD problem initially. Such things can also get worse and change in appearance with continued friction from masturbation or, in your case, if there is increased chaffing in relation you your recent weight gain.  My advice is to try your best not to worry.  If this had been something serious I suspect your doctor would have detected it.  In addition, if the problems persists or gets worse, my advice would be to continue to work with the doctor you have. He sounds to be on target and level headed.  If you go to a new doctor that person will (or at least should) start from the beginning, repeating much of what has already been one.

I hope this helps. EWH

[Edward W Hook, MD]

Just one comment.  It would be absolutely consistent with psoriasis to have dilated capillaries as part of a lesion.  there remains NO reason to worry that this might be an STD.  EWH

[JohnT333]

I had gone back to the dermatologist a week after the first visit.  I was getting some irritation from the antifungal (oxicaonazole) they had given me, and so they told me to discontinue it, as intertrigo was unlikely since it had no appreciable affect.  The resident dermatologist came in and looked me over quickly, and he surmised it could be some type of psoriasis (plaque maybe) and that he thought it was nothing.  He assured me it was not an STD nor an infection, but rather some benign irritation.  They gave me an Elidel sample and told me to use just that.  

I know I must sound paranoid, but seriously, the red capillaries are increasing all around the penis corona, and there is still a little 1 mm patch (white/skin colored) on the tip of penis next to urethral opening.  It does not really itch anymore and just is irritated.  If this was happening to your penis...I promise you would be concerned too.

I will continue to post here as things go on, but this seems to be a very slowly evolving situation, and I just can't seem to find a good remedy, the Elidel seemed to work at first, a little.  But now there is no help from it and I see the red area around the corona growing.  I hope this is just some odd virus that will clear my system, but I still have great anxiety about what it actually is.  Any help here is greatly appreciated.

[JohnT333]

I went to a dermatologist as the redness seemed to spread around to the right side of corona a bit more, and she told me it was not contagious and looked like it was possibly intertrigo, which she said is basically yeast or similar bacteria/fungal irritants and that I should continue using OTC hydrocortisone and gave me a bunch of samples of oxiconazole nitrate cream which from what I read is similar to other anti-fungal creams.  I had tried clortrimazole before (lotramin) and it didn't really work, and I told her this.  I suppose this one I have now can do more?  Still not sure that this is the answer but I will follow what I have been told and post the progress here.

[JohnT333]

Thanks for that follow up.  I assumed that the lotramin couldn't go on forever, and I will try to use come hydrocortisone to see if that works.  Worst case I can just use the remaining lotramine if for some reason it causes a fungal problem as some people suggested it may.

Tysonitis was what the other doc had said it may be, which I think basically was him suggesting that since it is irritation around that area, but without any other real detail on how/why, so I think that tysonitis may be just a general term for an unknown irritation there.

My thoughts all along was that the increased stress and work along with no exercise and small weight gain may have just set me up to get a routine infection or irritation, which normally would be no big deal.  I will take your advice and post a follow up later about how the condition has progressed, so that others can use it for reference.  Thanks again.

[JohnT333]

One last little set of data:  

Several years ago I was with a girl who had never had sex, and after we dated she tested positive for HPV so I assume I at least had it, could that factor in even though I never saw other signs.

I had pityriasis on my body 2 years ago, not sure if that could factor in also.

[JohnT333]

Thanks so much for your response.  I know that most likely I am overreacting, it just caught me by surprise and being away from my girlfriend for work and the stress may have added to the anxiety level I have felt over the symptoms.  

The doctor I got at the free clinic was great, very intelligent and kind, and he did reassure me, but the main problem is that he is very busy and I cannot just keep bothering him over what I think are new or developing symptoms, that is why I have come here.  I am moving soon and can't go back to see him, which is a shame, good doctor's are precious.

I have read online that using a cortisone cream may actually promote fungal growth and cause an increase in irritation, but is that worth a try?  I have been using the lotramin consistently for over a month, and it hasn't really gotten worse or better, so I am considering giving those kind of things a shot.  I just don't want to make anything worse.
Q1:how long is too long to use lotramin?  any downside to continued use?

Q2: Do you have any experience with Tysonitis?  Unfortunately when I look it up there is only very small anecdotal mention, with most results turning up things about Mike Tyson! haha.  I figure at this point the only way I can proceed is to eat better, exercise more, and try no to worry myself sick.  I will try not to irritate the area with dry masturbation, and continue with the lotramin.

Thanks again for your comments and if you can add any additional details on tysonitis and the questions I asked I would greatly appreciate it.