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What Causes Reddish Spot On Penis Glans Post Protected Sex?

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Posted on Sat, 19 Sep 2015
Question: Once month ago had protected sex with CSW. It was fully protected with condom followed with a hand job. During this one month there was no signs and symptoms.
Last week i.e during the fourth week, i washed my utensils and mistakenly rubbed my penis. Next morning seeing a reddish shiny spot (attached with it) on the glance of the penis. In the morning it looks more red while later seems to less during day time. It is shiny,no pain. Please see attached.
Went to a STD specialist and he took sample from the spot, ordered blood and urine test for all STD. Please see the report at the end of 4th week.
All reports negative except, candida glabrata. he prescribed me itraconazole 400mg tablet in one day and cream for seven days..
Three days passed, not seeing any betterment.
Please advice.....what your expert opinion on this spot, whether its purely fungal or any other thing you are suspecting and medication?
doctor
Answered by Dr. Dr. Kakkar (49 minutes later)
Brief Answer:
Dermatitis Or FDE; topical steroid cream would work better

Detailed Answer:
Hello. Thank you for writing to us.

I have gone through your query and I have understood it. I have also reviewed the attachments.

I can see a red circular patch on glans.
This does'nt seem like an STD. Does'nt look candida either.
Candida glabrata is anyways part of normal commensal flora and is not usually pathogenic except in immunocompromised and I rule that out as a cause for this patch.

This is most likely either a patch of 'eczema/ dermatitis' which is incidental Or a 'fixed drug eruption' (FDE) i.e a reaction to an Oral drug e.g either a painkiller or an antibiotic that you might have taken during that time.
If I was the treating doctor I would suggest you to apply a moderately potent topical steroid cream e.g either mometasone furoate 0.1% cream Or Triamcinolone acetonide 0.1% Or fluticasone propionate 0.05% cream, twice daily, over this patch, for a few days.

Can you tell me the antifungal cream that you have been using over this patch?

As far as your sexual act is concerned which was protected with a condom but should be followed by screening for STDs as a protocol because a condom does not provide protection against all STDs like herpes, syphilis and Hpv. Nevertheless, a condom provide adequate protection against Hiv, Gonorrhea and Chlamydia.

Your tests for Herpes, Syphilis and Hiv are negative and conclusive. Therefore you have nothing to worry about STDs.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (34 minutes later)
Thank you so much doctor,

I was prescribed TRAVOCORT CREAM ( isoconazole nitrate 10 mg and diflucortolone valerat) once for seven days.

Can you please tell me whether I can have sexual encounter with my wife. Really I am scared to touch her even......I was praying that you should be the doctor here to reply my answer specifically.

Can I leave behind this incident, I am really very very stupid to do this kind of act. Since yesterday, I am noticing some minor itching without any redness in different parts of my body. I am not sure whether it is because of my over consciousness or may be skin dry, please advice....

Do you suggest me any particular test, please tell me....

Again Thank you for your service and time,
doctor
Answered by Dr. Dr. Kakkar (4 hours later)
Brief Answer:
You seem to be clear of STD's; No need for further lab tests

Detailed Answer:
Hi.

The cream that you are using already contains a topical steroid i.e diflucortolone valerate. It is a very potent steroid plus there is no need for an antifungal i.e isoconazole nitrate, as this is not a fungal infection.
I would rather suggest a moderately potent steroid Cr. e.g mometasone furoate 0.1% Or triamcinolone acetonide 0.1%.
I think there should not be any problem in having sex with your wife as your screening tests are clear after 4 weeks of protected sexual encounter. You can out this incident to rest.
Only Hpv cannot be reliably confirmed Or ruled out in males unless one develops clinically visible warts. There isn't an approved test for Hpv in males. Rest all STDs have been ruled out.
For itching, you need to treat it symptomatically. I don't think it is related in anyways to this particular sexual encounter.
You may take a tablet of cetrizine 10 mg once daily for symptomatic relief from itching. Topically you may use a soothing anti-itch lotion e.g calamine.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (58 minutes later)
Agreed doctor that HpV can not be reliably confirmed. But do you think HpV manifests as a reddish patch like me.
What about Lichen planus and psoriasis!

Before concluding, do you have any clinic in XXXXXXX if yes then please provide me the address and contact number. Will be more than happy to consult in person.
doctor
Answered by Dr. Dr. Kakkar (7 hours later)
Brief Answer:
Not Hpv

Detailed Answer:
Hi.

No. Hpv does not manifest as a flat, reddish patch like this one. It usually presents as skin colored, rough, growths on genital skin Or mucosa.
I did considered it as a non-specific eczema/ dermatitis initially, if you can refer to my first reply. Lichen planus, psoriasis, seborheic dermatitis etc do fall in the broad cateogory of eczema/ dermatitis but I won't qualify it as one of these entities specifically as yet because you already have been using a steroid based cream for 3 days and all these entities are steroid responsive and the picture does get modified clinically, on application of topical steroids.
I have myself asked you to apply a moderately potent topical steroid for 10-14 days and see how it goes.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (9 hours later)
Thank you so much Dear Dr. Kakkar.....
doctor
Answered by Dr. Dr. Kakkar (10 minutes later)
Brief Answer:
You are welcome

Detailed Answer:
Thank you for writing to us at healthcaremagic.

Kind regards
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Reddish Spot On Penis Glans Post Protected Sex?

Brief Answer: Dermatitis Or FDE; topical steroid cream would work better Detailed Answer: Hello. Thank you for writing to us. I have gone through your query and I have understood it. I have also reviewed the attachments. I can see a red circular patch on glans. This does'nt seem like an STD. Does'nt look candida either. Candida glabrata is anyways part of normal commensal flora and is not usually pathogenic except in immunocompromised and I rule that out as a cause for this patch. This is most likely either a patch of 'eczema/ dermatitis' which is incidental Or a 'fixed drug eruption' (FDE) i.e a reaction to an Oral drug e.g either a painkiller or an antibiotic that you might have taken during that time. If I was the treating doctor I would suggest you to apply a moderately potent topical steroid cream e.g either mometasone furoate 0.1% cream Or Triamcinolone acetonide 0.1% Or fluticasone propionate 0.05% cream, twice daily, over this patch, for a few days. Can you tell me the antifungal cream that you have been using over this patch? As far as your sexual act is concerned which was protected with a condom but should be followed by screening for STDs as a protocol because a condom does not provide protection against all STDs like herpes, syphilis and Hpv. Nevertheless, a condom provide adequate protection against Hiv, Gonorrhea and Chlamydia. Your tests for Herpes, Syphilis and Hiv are negative and conclusive. Therefore you have nothing to worry about STDs. Regards