Hi,
Thanks for writing to us.
Severe itching in localised area could be lichen simplex chronicus. Continuous itching and scratching can lead to swelling, thickened skin in concerned area and discoloration of skin. Another condition that can cause itching in shaft is lichen sclerosus et atrophicus. It presents itself as a discolored white area with severe itching. As the lesion progresses, the foreskin may become tight and it becomes difficult to retract it.
Also nodular scabies can present with severe itching in generalis
So to make diagnosis, I would like to know
Since how long are you having this.
Is the itching mainly in night.
Any other body parts that are affected like finger webs, wrist underarms, chest, inner side of thighs etc
If your foreskin is tight
If itching developed prior to depigmentation of area.
Please answer these queries, so that I can make a diagnosis and suggest appropriate treatment.
Hope this helped.
Take care
Patient replied :
Hello
This happened 2 days ago with minor itching sensation. But now its itching all the time constantly. I am struggling to sleep, i tried hot water dip and ice, it worked to a certain extent. I tried applying eurax cream, i started to get burning sensation. Its has come to a point where its constantly ithcing throughout the day and i cant focus. My scrotum has got bulb like features throughout and it itces quite bad. The other parts of the body are legs and back side of my body. My thighs an groin are fine. The scrotum and shaft of the penis is swelling as time goes by. I dont know if my foreskin is tight but i have got itching burning sensation throughout the shaft and underneath and at the scrotum as well. Are there any pills i can take or steroid cream? . How long does this take to cure? an d the last question is i always had this discolouration on my head of penis ever since i was a child. How can i get that sorted. This is the first time i had itching and i am 24 years old patientold. The discolouration/dipigmentation was there from childhood, it did not happen bcz of this. As you can see from the picture the shaft is swollen now, when i run my hands through it i feel there are uneven bumps and the scrotum has got lump features. The more my scortum and shaft swells with these lump features its getting tighter. I can see some dote minor bumps on the penis head. Many thanks
Hi,
Thanks for providing all the details.
With the details provided we can rule out lichen simplex chronicus and LSEA.
Now the itching that you have could be nodular scabies or contact dermatitis.
To treat both of these, I would advise that
1)You may take one tablet ivermectin 12 mg stat( ie just one single dose,to be repeated after a week if required) and apply permethrin 5 percent neck downwards overnight just once. Eurax or crotamiton is a mild antiscabetic. Twice daily applications at least for five days are suggested for antiacabetic effects.
2) you may take oral antiallergic like levocetirizine 5 mg twice in a day. If itching still persists you may double the dose.
3) Apply steroid cream like mometasone cream twice daily over itchy areas till itching subsides.
Now to treat the depigmentation in affected area(it could be vitiligo), twice daily application of a mild steroidcream like fluticasone cream and tacrolimus ointment 0.1% would be required for weeks to months.
I would appreciate if you could meet a dermatologist nearby prior to starting these medicines.
Hope this helped
Patient replied :
Hello
Thank you for getting back. Is there any way you can send me the prescription so that i can go and buy from the pharmacy. I live in UK. The way it works here is that i need to see my GP and then he would need to refer me to a dermatoligist which will take 2-4 weeks. Private dermatologists here are expensive. I went to the pharmacy and was told i need signed prescription for this. Or can you send me a referral letter so that i can go to my GP and show him, so that he can approve the medications rather than waiting a month, your a dermatologist, so is there anyway you can write a referral letter with medications listed, thats how it works here. My last questions is that, how long does it take for the swelling to go down once i start using these medication, my foreskin has started to swell as well. As days goes by it gets bigger. I started taking benadryl which has helped the itching. Many thanks
Hello,
Unfortunately, we provide only email consultations, and we are not allowed legally to give any precscriptions or referral letters online without physically examining the patient.
I am sorry for the inconvenience.
Regards.
Patient replied :
Hello,
Unfortunately, we provide only email consultations, and we are not allowed legally to give any precscriptions or referral letters online without physically examining the patient.
I am sorry for the inconvenience.
As of now, kindly update me after 2 weeks, there should be a lot of recovery by then.
Regards.