Brief Answer: kindly send good resolution pictures & details Detailed Answer: Hi, Welcome and thanks for posting your query to the forum. I can understand your concern for the stitch like rash under your penis head. I have gone through your pictures amongst which two are blurred and one is showing bead like structures at the rim of penis. There is quite mild redness and appears to be normal in nature. I request you to kindly send few more good resolution pictures focusing the penile area and it would be best if you can mark the exact area of your concern. I also request you to elaborate certain important points: - Kindly elaborate the exact concern of yours. What is the exact problem of stitch like rash under your penis head. How and when it started and what are you experiencing in the same (are these the bead like structures you are concerned with). - Any history of unprotected intercourse if yes then the was it with professional or a known person. tell me the exact time period of the intercourse and the starting of the symptoms. - Any itching burning or pain over penile area. - Any discharge of pus or any other eruptions on the penile area in recent past. - Can you please tell me why you were tested for Gonorrhea and Chlamydia. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)

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Brief Answer: “Pearly Penile Papules” & “Fordyce spots” Detailed Answer: Hello young man, Thanks for your swift follow up. I can understand your concern for the problem over the penile area. It is really distressing for a man to have anything unusual on genital area. Now getting a clear information for the concern of bead like rash and thoroughly analyzing the picture along with the history - To begin with let me reassure you by the most important thing that you do not have any kind of sexually transmitted disease including herpes, Gonorrhea and Chlamydia, warts, HIV or syphilis or any other major dermatological problem. This is quite evident by all the tests done and which came negative. The spots on the rim of your penis are “Pearly Penile Papules” and spots on the under-surface of penis are “Fordyce spots”. Both of these are simple, benign and usual normal condition of the penile area. The Pearly Penile Papules are small, pearly or flesh-colored, smooth, dome-topped bumps situated around the corona or sulcus of the glans. Fordyce spots are pinhead size or slightly larger bumps present over mainly the under surface of the penis i.e. on the frenulum area. Basically both of these are proliferation of the normal oil glands which are present over this area. These are totally asymptomatic (without any problem) and are most commonly confused with genital warts in there initial course of appearance. A close examination is the must to differentiate one from another. There is no need of any treatment in this condition as it is totally normal condition. If at all some person are panicky then we do remove these with radiofrequency ablation. Looking at the picture in detail, the closest possibility is of “Pearly Penile Papules” & “Fordyce spots” only. By puling of skin, it makes the foreskin stretched and therefore both of these become more prominent on stretching of the skin. In my clinical practice I quite often see your kind of cases where after an incidence we start perceiving different kind of symptoms such as pain, burning, frequency of urination, testicular pain and many more related symptoms. All these are vague symptoms and are not related to any kind of Sexually Transmitted Diseases. In your case it was only brief oral sex which has the least possibility of any type of Sexually Transmitted Diseases. Therefore there is no need of any type of investigations too. So relax yourself and in my opinion there is no need to visit any specialist including urologist or anybody else. You will perceive the vague symptoms till the time you have the anxiety state related to the incidence. That is why I am again reassuring you that your problem is not related to any Sexually Transmitted Diseases and is totally a normal condition which most of males have. I hope the information will help you. I will be glad to answer any further queries or if not then can close the discussion and rate the answer. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)

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Brief Answer: no need to apply any cream Detailed Answer: Hi young fellow, As I said earlier that your conditions totally normal so there is no need to apply any cream for the same neither clotrimazole nor any other cream. It will be mere wastage of time as well money so do not apply anything. So do not use any medicine. I have seen many a times that young men like you gets quite anxious for the possibility of one or the other disease and apply too many of the unnecessary medicines which actually causes a lot of problems rather than improvement. In very anxious persons who do not want these then we go for radio-frequency ablation where the are removed by a machine. But as I said these are totally normal and are preset in most of men as normal structures. In your case also due to more of anxiousness and repeatedly watching the area you realized its presence after the incidence. So keep your nerves calm and relax for everything. A friendly suggestion for future is to use condoms in every type of contact. I hope the information will help you. I will be glad to answer any further queries or if not then can close the discussion and rate the answer. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)

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