Brief Answer:
You may be having
balanoposthitis with vitiligo.
Detailed Answer:
Hi,
After seeing photo and reading the history, I think that you may be having candidal balanoposthitis and vitiligo on the prepucial skin. You had
tuberculosis. So, I think you may be poor in immunity. And that is why, you got
fungal infection caused by Candida albicans. And the de colorisation on prepucial skin may be vitiligo and that would be precipitated by infection. You should be investigated to rule out DM,HIV and other immunocompromised conditions.
Candidal balanoposthitis may be treated by antifungal therapy. I usually prescribe itraconazole or
ketoconazole for two weeks. I advise to apply antifungal cream like
clotrimazole twice a week. I suggest to have Sitz bath in dettol water. If there is itching, I prescribe antihistaminics like
levocetirizine.
I think you are more concern with discoloration. And that may be vitiligo. It is not serious condition. Take it easy. Still, we can try to revert pigmenation. I usuallyprescribe Tacrolimus ointment 0.03% initially, if no irritation, it may be increased to 0.1 %.
Neopsoralen tablet 25 mg may be taken for long period under supervision of a doctor. If no response after long time , accept it and leave the treatment.
I also advise
circumcision in my patient having recurrent candidal balanoposthitis.
I hope you got my answer. Still, any query... you are welcome.
Thanks.
Dr. Ilyas Patel MD