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Suggest Treatment For Red Spots On Glans

Posted on Wed, 8 Oct 2014

Question: Dear sir i had some red red spots on my glans about 4 weeks ago. It went away with antifungal treatment. After all becoming ok i masterbated harshly by rubbing glans on bed. Next day i saw a red area at the end of penile shaft after retracting by foreskin completely. I applied antifungal cream but yellowish white substance stated collecting there. i also had discomfort in pulling down my foreskin. I saw a sore on side but they never looked as oozing. I went to doctor. My vdrl test came non reactive so he said its herpes. please help

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
Traumatic Balanoposthitis

Detailed Answer:
Hi
Welcome to healthcare-Magic
Greetings of the day

Dear MR XXXX,

Thanks for providing the clinical photograph. From the clinical picture there are raw excoriated area on glans especially near the corona(rim or neck of glans) and undersurface of prepuce. In the absence of any exposure due to unprotected sex, it is likely to be due to trauma. It has caused Balanoposthitis( inflammation of glans ands undersurface of foreskin). The yellow secretion is pus discharge associated.

I would suggest you the following which will definitely help relieve the fungal Balanoposthitis

1. Hot Seitz bath: Add a handful of salt in a small tub of warm water. Sit in it for 15-20 minutes, before taking bath. Pull back the skin gently and clean the whitish /yellowish secretion known as smegma which is infected. Repeat it twice a day. take a good bath after it
2. Rule out Diabetis mellitus by getting Blood sugar level done.

3. Dry the skin well after hot bath__ Apply mixture of Betamethasone and Clotrimazole ointment over the glans after pulling back the prpuce. Replace the prepuce to its normal position after thoroughly applying the ointment. Apply it thrice a day.
Also apply Soframycin Ointment at bedtime

4. Good personal Hygeine and maintaining area clean and dry especially after voiding

In case you need any further assistance, will be glad to assist you.
Do keep me updated about progress.
Wishing you happy and healthy life

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Kishore Kaltari (19 hours later)

Thankyou very much Doctor. I am already washing with salt water and its working i hope. But when i apply the cream u mentioned it mixes with pus and becomes thick.Can you suggest some oral tablets to beat the infection.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
Local treatment is very important

Detailed Answer:
Hi
Dear XXXX,
As the infection is localized and non invasive , local treatment with anti fungal and antibiotic cream is all that is required. In fact local treatment is very much necessary.

I would also suggest you the following antibiotic for oral use

1. Cap Doxycycline 100 mg twice a day for 5 days
2. Tab Ibuprofen 400 mg thrice a day for 3 days
3. Cap Pantoprozole 40 mg once a day
Discuss about these medication with your treating doctor.

Do get back to me with clinical photograph after having started the treatment for 2 days for further assessment.

Regards
Deepak

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Deepak Kishore Kaltari (11 days later)

dear sir
I have uploaded the latest pictures. I visited a dermatologist whose prescription i have attached. He asked if i had taken any anti biotic before the problem occurred and i remembered i had taken 10 tablets of O2, oflaxicin and ornidazole tablets for loose motion. he told me the problem was due to antibiotic taken. He prescribed me anti allergic tablet. Thats why i didnot start the tablets told by you.
now i have discomfort but there is pus kind of thing below my foreskin. i suspect if its oozing from the red spots.
I will able to go to same doctor again at least for 10 days from now. please suggest medication.
One more thing is could you please consult a dermatologist too.

Answered by Dr. Deepak Kishore Kaltari (12 hours later)

Brief Answer:
Local Steroid will help

Detailed Answer:
Hi

As you are HLA B27 positive, the is high risk of genital ulceration. Hence antibiotic both oral and local are to be avoided when there is ulceration.

The Dermatologist has prescribed Cetrizine which is antihistamine. I would also recommend local application of Betnovate ointment which is Steroid and will help in resolution of lesion. If the lesion still persist then oral Steroid will be required.
Do keep me updated about progress.

Take care

Best regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Kishore Kaltari (4 days later)

Dear sir
I have uploaded latest pictures.i am washing with salt water. It pains a bit while pulling my foreskin back. the lesion also pains when touched. i am washing with salt water and applying BETNOVATE(BETAMETHASONE VALERATE CREAM IP). Its very frustrating because its long since its not becoming alright. i am not even able to masturbate. sometimes the glans is itching too.. plz help

Answered by Dr. Deepak Kishore Kaltari (23 minutes later)

Brief Answer:
Apply Candid B

Detailed Answer:
Dear Mr XXXX,

Apart from Betamethasone I has suggested you to apply mixture of anti fungal like Clotrimazole and steroid that is Betamethasone. I would suggest you to use Candid B Ointment.

Take Care

Regards
Dr Deepak

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Prasad