and Treating Glans and Prepuce Issues: A Patient's Journey - Dermatology

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It sounds like you have been experiencing a challenging journey with your glans and prepuce issues, and I understand your concern regarding the prolonged symptoms. Let's break down the situation and discuss the potential causes, treatments, and management strategies.


Understanding the Symptoms
From your description, it appears that you initially experienced itching and redness on the glans, which was diagnosed as eczema by your urologist. Eczema, or dermatitis, can manifest as red, itchy patches and can be exacerbated by irritants or allergens. The use of a weakly acidic wash may have contributed to the dryness and subsequent skin breakdown, leading to the development of fissures or raw areas on the glans and prepuce.


Treatment Journey
1. Initial Treatment: The initial treatment with a topical steroid (likely the medication you referred to as "美康") was appropriate for eczema. However, if the skin becomes too dry or if there is an allergic reaction to the product, it can worsen the condition.

2. Follow-Up Care: The recommendation to wash with only water is crucial, as harsh soaps or cleansers can strip the skin of its natural oils, leading to further irritation. The antibiotics and injections you received suggest that your healthcare provider was concerned about a possible secondary infection, which can occur if the skin barrier is compromised.

3. Dermatology Consultation: It’s good that you sought a second opinion from a dermatologist. The switch to a different topical medication (比達爽) indicates that your condition may have required a more potent anti-inflammatory treatment. The improvement in the prepuce area is a positive sign, but the persistent redness on the glans suggests that the inflammation may still be present.


Current Concerns
You mentioned that it has been three weeks since the onset of your symptoms, and while some improvement has been noted, the glans remains red and flat. This could indicate several possibilities:
- Chronic Inflammation: The redness could be due to ongoing inflammation, which may take time to resolve fully.

- Infection: If there is a secondary infection, it may require a different approach or a longer course of treatment.

- Allergic Reaction: There could be an allergic reaction to one of the topical treatments or even to the materials in contact with the area (e.g., certain fabrics, soaps, or personal care products).


Recommendations
1. Follow-Up Appointment: If you have not seen significant improvement after three weeks, it is advisable to return to your healthcare provider. They may consider a more thorough examination, possibly including a swab to check for infections or a biopsy if there is concern about other dermatological conditions.

2. Skin Care Routine: Continue to keep the area clean and dry. Avoid any harsh soaps or irritants. If you are using any topical treatments, ensure they are applied as directed and monitor for any adverse reactions.

3. Consider Allergies: If you suspect that a product may be causing irritation, try to eliminate it from your routine and observe if there is any improvement.

4. Patience and Monitoring: Skin conditions can take time to heal, especially if there has been significant irritation or damage. Monitor your symptoms closely, and keep a record of any changes or reactions to treatments.

5. Potential Referral: If your symptoms persist despite appropriate treatment, a referral to a specialist in dermatology or urology may be warranted for further evaluation and management.


Conclusion
Your journey with glans and prepuce issues has been understandably distressing, but with careful management and follow-up, there is a good chance for improvement. It’s essential to maintain open communication with your healthcare providers and advocate for your health as you navigate this process. Remember, healing can take time, and it’s important to be patient while your body recovers.