Unknown diagnosis (LS, Bowen disease, dermatitis) – circumcision did not help
Posted , 11 users are following.
Hello everyone,
I have been struggling to get a definitive diagnosis for a year or even longer. Shortly speaking, over the past months, I have visited a number of urologists and dermatologists, did various tests (HIV, STD, blood, urine – all is good) and then was prescribed antifungals, antibiotics, creams for different skin conditions (including for psoriasis and dermatitis). Unfortunately, it did not help but some red spots started appearing all across my glans.
There are the following characteristics:
• the spots (plaque) change their colour from time to time (I don't know why but perhaps because of some temperature changes). Sometimes they are red, pink or even translucent
• the plaque was spreading for some time (when I was applying some creams, I haven't used anything for the past three or four months – looks the same) but then stopped at some point. I don't know whether it's because I stopped using creams or because this is the final stage of its progression
• the spots do no hurt or itch. However, they are often sticky
So, the thing is that most of those specialists I have visited said that there was no chance that it would be something serious but looked like balanitis or candida. What they advised was to get circumcised. So I had my foreskin cut off two months ago and during the recovery period the spots covered with a yellowish crust. I thought it was rather a positive sign and so hoped that as soon as I get rid of the crust the spots would disappear too. However the glans look much better now, having somewhat a better skin colour, the plaque remains. Overall, circumcision might have helped a bit but it has not solved my problem.
It is incredibly annoying that the doctors assured me that the spots would disappear as soon as I have a circumcision. It did not happen but remains quite a big problem for me. Another thing: it seems that there is no chance to get a biopsy in my city so I need to move somewhere else for this procedure. That is also a shame that most of the dermatologists do not have much experience dealing with penile skin conditions.
Do you think it is something serious?
These two pictures are taken two months after the surgery.
And these three are before the surgery, when the spots looked very inflamed.
0 likes, 15 replies
james16984 recorder7754
Posted
the pre-circumcision photos do look like balanitis, I suffered this for years and my glans looked very similar. I seem to have grown out of it, mainly as my foreskin is much looser nowadays and if it does flare up I just keep it back until it clears. Your glans does look less inflamed now you've been circumcised, hopefully it will clear up eventually for you.
Wee_Dugie recorder7754
Edited
You need to see a Dermatologist who is a specialist in Genital Skin Disorders / Conditions
Let this be a warning to other readers that circumcision does not cure everything it is suggested to by Medical Professionals
james16984 Wee_Dugie
Posted
Unfortunately some medical professionals see circumcision as a cure-all for any problems, and in a lot of cases this is not true. I think in my case I was lucky that my doctor told me to go away and stretch the foreskin and if it didn't work to come back.
Wee_Dugie james16984
Edited
Fully agree - in some countries of the world some medical professionals regard fee-paying patients as a source for maintaining their income - anything that equates to 'go away and try a range of different options first' simply is not what some medics will do
recorder7754
Edited
Update: I have finally found a dermatologist specialising in oncology and venereology, who also performs a penile biopsy. Frankly speaking, I am really happy to meet this doctor, as he seems to be the most experienced and knowledgeable one, especially in the area of uncommon penile skin conditions.
Investigating some zoomed-in pictures of the rash on my glans, he has concluded that it is unlikely to be oncology (still possible though) but rather be a lichen sclerosus. I presented him a list with all medicine I have used over the past year also showing pictures before- and after circumcision, he underlined that after the surgery it looks much better with some signs of a slow recovery.
Tomorrow, I am having a penile biopsy and its results will be available within two weeks. Now, I hope that the condition went into remission and will not get worse during my recovery. If the doctor is right, this is the early stage of LS progression and can be managed more easily.
recorder7754
Edited
Hi everyone,
So I have received my biopsy results which came back negative for both lichen sclerosis and penile cancer. However, in the description section, the form says that I have chronic balanitis (chronic inflammation of penis glans). While waiting for the results, I have also been applying a cream prescribed by my dermatologist to speed up the recovery (called Dermaskin). The cream has proved to be quite effective as it reduces inflammation and now the overall skin colour looks much healthier. My doctor asked me to use this cream for three more weeks as there is some improvement. Still, the shiny rush does not seem to be disappearing.
Also, it is hard to explain how exultant I am not to have penile cancer or LS but there are still a few things that bother me quite a lot:
maxpower2020 recorder7754
Posted
It's a prescribed cream or over the counter? What are the ingredients? It's good that it's helping a bit.
I don't think anyone can tell you what the trigger for this condition was at this point. And you're right, most physicians don't know how to deal it since these penile conditions aren't specifically written in urology or dermatology textbooks.
Any history leading up to it? Sexual encounters? Your age? Other health conditions? I notice other posters with similar symptoms to yours seem to have a dermatological condition somewhere else on the body or a familial history of one.
recorder7754 maxpower2020
Edited
Hi there,
Many thanks for your response.
It's an over-the-counter cream which contains a bunch of various ingredients such as sodium salt (tannin), glycerol monostearate-macrogol, phenoxyethanol, isopropyl palmitate, propylene glycol and some others. Overall, it is a cream used for treating mild dermatitis, skin recovery and inflammation reduction (the cream is called Delaskin, produced in Germany).
I am 23 years old. The last sexual intercourse was about a year ago. Apart from this skin condition, over the past year, I have also been having slightly enlarged thyroid glans (a doctor said it was not really a problem), some sleep problems (perhaps caused by that huge amount of stress I have been having recently), feeling like a have a lump in throat, sinusitis and reduced sexual desire. Also, I do not have any other skin condition on my body.
Background: a year ago there was some dryness of my glans which somewhat bothered me during sexual intercourse, so I decided to visit a doctor. My doctor prescribed me various creams, antibiotics and emollients – to no avail. Then, a whitish spot appeared close to the urethra and was there for a few months. Once I started using some other creams recommended by some other dermatologists, the spot tarnished but other red/purplish spots appeared; overall the glans looked inflamed, thinned and shiny. Thereafter, I visited a dermo-urologist who, after having conducted about five STD tests, found trichomoniasis and treated it with very strong antibiotics and creams (still not sure whether I really had that infection). Well, after this intensive treatment, the spots kept on spreading across the glans – with no sign of improvement. The doctor concluded that it was lichen sclerosus and prescribed me hydroxychloroquine. As a result, I decided to give up this treatment because I did not see the connection between my skin condition and the anti-malaria medication. Later, I had a circumcision, and so the condition has improved. More recently I have been using this Delaskin cream over the past two months which has somewhat helped, but the condition is still there and not changing at all.
maxpower2020 recorder7754
Posted
My condition started with dryness as well and now looks similar to yours. There's no pain and itchiness, but the skin does feel sticky as well. I attached a photo.
The cream contains anti-inflammatory ingredients so it will help reduce the redness. If you try taking over the counter medication like Ibuprofen or naproxen they should help as well. However, I think this is only treating the symptoms and not the actual cause, which brings me to the next point....
If it's something autoimmune related like lichen sclerosus, psoriasis, eczema , etc. of the penis (from the research I've done, they look very similar in the early stages) then there's no guarantee it can be cured, only controlled as it's your own body's defence system that is doing the damage. Unless of course there is an outside factor that is contributing to the over reactive defences which is the next point...
There is bacteria or fungus somewhere on the skin or along the urinary tract constantly causing an immune response and never allowing the skin to fully heal. Since you mentioned trichomoniasis, perhaps there is still mild growth in the prostate for example that makes it's way down to the glans.
The hydroxychloroquine is used to treat various autoimmune disorders so maybe it would have helped. Additionally, enlarged thyroids are also indicative of issues with the immune system.....Just my thoughts, I think we need a really good doctor to connect all the dots systemically to figure this out.
mike81573 recorder7754
Posted
i think it is lichen planus
recorder7754 mike81573
Posted
Why do you think it might be lichen planus? I have checked all possible symptoms, and my problem does not seem to be fitting the description of this skin condition you have mentioned.
terry01090 recorder7754
Posted
hi. i also have a similar issues with some fairly similar symptoms, redness around the glans etc. my symptoms probably arent quite as drastic as yours. Just because you have had a negative biopsy for Lichen Sclerosus, that does not mean you definitely dont have it. its very dependant upon how far you are into the disease etc. I would recommend booking an appointment with a dermatologist called Professor Bunker in London. He is the top male genital skin dermatologist in the UK and he sees hundreds of penises monthly so he'll he able to diagnose you. Based on my symptoms being similar to yours and my diagnoses from him being Lichen sclerosus, i think thats probably what you have. So basically after circumcision, the glans skin can take between 6-24 MONTHS to fully keratanise (toughen up). this provides your skin with a far better back drop to fight the disease. Your condition definitely looks improved after your circumcision, maybe it will just take a few more months for it to fully sort itself out. ive spoken to men on different forums, one man said it took 4 months for the skin to sort itself out and now he has no symptoms. Another man said it took him around 12 months to get to a point where he had no symptoms of his Lichen Sclerosus. now of course im not saying LS is categorically what you have, because it may not be.
recorder7754 terry01090
Posted
Hi there,
Many thanks for your response.
I really appreciate your advice. Unfortunately, I am out of the UK right now and will not have an opportunity to visit London in the nearest future. Perhaps you know some specialists based in Brussels?
That is very interesting, thanks for sharing this information with me. Well, almost four months have passed since circumcision, and the condition has somewhat improved. I do hope that the symptoms will regress in the following months. A quick question: do you think my low sexual drive is connected to this condition? Having done all possible blood and other tests, my hormones and other things are okay, but for some reason I do not have a morning wood and overall sexual drive is very low. I am just trying to figure out whether this is rather a psychological problem than something connected to this skin condition.
davidh12391 recorder7754
Posted
Hi mate, have the same issue as you (could have wrote your post my self) inboxed you, check your messages
Ivank11 recorder7754
Posted
Hi, your condition does look a lot LS I know you have had a biopsy and it came back negative never the less it could be wrong. your condition has improved a lot since you had the circumcision I think it will continue to improve as it can take several months or even a year or more before the discoloration fades and it might not go completely. if you had some steroid cream it may help with the recovery.