Psoriasis Doctor

Question:

Ignorant is a nonjudgemental term.  The procedure is unnecessary and very painful.  I was circumsized at birth, but I’d never do such a thing to my hypothetical future son.  The Roman Catholic Church certainly doesn’t require it.  In fact, I’d bet that the Pope, who is from Poland, is uncircumsized.  May I remind you that some cultures also practice "female genital mutilation," which is MUCH worse.   – Hide quoted text — Show quoted text – > Gee, Bryan, > I feel kind of left out.  Care to add some ignorant Catholics to > your list, like me?  Some diverse cultures have practiced > this medical procedures for thousands of years.  That’s a > lot of folks to call ignorant.  Perhaps someday we can > become enlightened enough to judge people for their > religious beliefs like you do.  Aint no P on my PP > Jim(never thought I’d talk about my "thang" worldwide) Herbert. > (snippage) . . . . . . . . >Usually it is.  It is mutilating surgery, performed on a non-consenting >little person by ignorant–Jews and Muslims who do it for religious >reasons excepted–people who don’t know any better. >– >Bryan >who supports the creation of  alt.nudist >with NF as moderator

– Bryan who supports the creation of  alt.nudist with NF as moderator

Response:

Thanks for the responses to the original post.  Just a couple additional points/questions: >Most obvious of these differences is the simple fact that this >prepuce area is a moist, dark, covered area.  This __GREATLY__ >increases the chances that organisms will grow there.  I have RARELY >had success treating this area for __any__ disease without addition >of an anti-yeast topical added to the mix.

My dermatologist(s) never found evidence of a yeast infection, but did prescribe multiple anti-yeast medications with little effect: OTC antifungal fungal creams, Mycolog II anti-fungal/steroid cream, & even a 1-week course of oral anti-fungals. >Soooooo, if the occlusion of this area is accepted as the primary >difference between this spot and others on the skin, we can >alleviate this situation by circumcision.  Regardless of the >national anti-circ frenzy currently extant, the truth of the matter, >dermatologically, is that we see vastly more skin disease manifest >itself beneath an intact foreskin than we ever see in the circ’d >male.  Soooooooo, sometimes we are forced to recommend this.

I would definitely have the circumcision in a heartbeat if the chances are that it would cure the problem.  My main reservation has been a fear of making the condition worse.  You seem to indicate most people see improvement with this procedure? >>take a close look at any changes in soaps, personal lubricants, >sex partners, etc. that corresponded to the onset of this condition.

No changes I know of.  Have stopped using soaps, changed shampoos, etc. with no effect. >>does she have a history of thrush or chlamydia >Extremely important, and excellent point.  Another –>  diabetes >makes candida (yeast infections) much easier to transmit.  Make sure >you are tested for this.

No cultures have been positive (STDs or candida).  Blood sugar was also OK so no diabetes. >Well, I hope this little diatribe will help some guys out there.  My >office door is always open for questions.  Just set ‘em on my desk. >I’ll be right back.  ;-) >Dr. Joe

Thanks again.  I’m leaning towards the circumcision if matters don’t improve significantly within a couple months (6 months has been long enough!). – R

Response:

Gee, Bryan, I feel kind of left out.  Care to add some ignorant Catholics to your list, like me?  Some diverse cultures have practiced this medical procedures for thousands of years.  That’s a lot of folks to call ignorant.  Perhaps someday we can become enlightened enough to judge people for their religious beliefs like you do.  Aint no P on my PP Jim(never thought I’d talk about my "thang" worldwide) Herbert.

(snippage) . . . . . . . . – Hide quoted text — Show quoted text ->Usually it is.  It is mutilating surgery, performed on a non-consenting >little person by ignorant–Jews and Muslims who do it for religious >reasons excepted–people who don’t know any better. >– >Bryan >who supports the creation of  alt.nudist >with NF as moderator

Response:

>>>When I had my circumcision done it was >>>soo painful, I couldn’t.walk for a

year! >VERY exceptional.  In unresponsive patients who have had this

snip Dr Joe, you really need to get out of the office a little more! Circumcision is usally performed within the first week of life    

Response:

> >>>When I had my circumcision done it was >>>soo painful, I couldn’t.walk for a > year! >VERY exceptional.  In unresponsive patients who have had this > snip > Dr Joe, you really need to get out of the office a little more! Circumcision is > usally performed within the first week of life

Usually it is.  It is mutilating surgery, performed on a non-consenting little person by ignorant–Jews and Muslims who do it for religious reasons excepted–people who don’t know any better. — Bryan who supports the creation of  alt.nudist with NF as moderator

Response:

Joe: Here is what I said about foreskin/glans irritation to Micheal that first posted the question, *snip*"Michael Iam sorry,and I know you have said before it isnt an STD,but this SO much sounds like a yeast infection that isnt healed properly,especially since you say it goes away and comes back.Since you are willing to try jsut about anything,and I dont know if this is available in the UK,but go to the pharmacy and hit the ladies section(you know what I mean) and get your self a tube of anti yeast,such as Monistat Michael Iam sorry,and I know you have said before it isnt an STD,but this SO much sounds like a yeast infection that isnt healed properly,especially since you say it goes away and comes back.Since you are willing to try jsut about anything,and I dont know if this is available in the UK,but go to the pharmacy and hit the ladies section(you know what I mean) and get your self a tube of anti yeast cream,regularly used when women have a vaginal infection.It wont hurt and it might help" But does anyone listen? nooooooooooooooo Jill – Hide quoted text — Show quoted text -> Dear Forum-ers: > I’d like to do what I can to help with this difficult problem.  This > will involve stepping on a few toes, but just hit <delete> if you > wish.  No problem. > Let’s take some statements made here, restate them, dissect them, > and try to re-assemble the parts which are factual and add some > suggestions. > First, >>The most probable diagnosis so far has been psoriasis (suggested > by a biopsy >>taken from the foreskin), but so far it hasn’t responded to > cortosteroids or >>other psoriasis treatments. > They teach us in residencies that if you need a biopsy to diagnose > psoriasis, you’re probably too close to the problem.  Well, that’s > only partially correct.  We use them in difficult areas such as the > moist area under the foreskin to _help_ us confirm or reject a > diagnosis.  Sir William Osler suggested to us, "Look for one > disease," but in this area, there is rarely just one problem to be > diagnosed and treated. > Let’s look at what’s different about this tender spot, over other > skin which may or may not show findings of psoriasis:  The skin is, > in fact, more tender, thinner, wetter, more bacterially > contaminated, more contaminated with yeasts, and much more > susceptible to the complications of topical medicines than almost > any other human body area. > Most obvious of these differences is the simple fact that this > prepuce area is a moist, dark, covered area.  This __GREATLY__ > increases the chances that organisms will grow there.  I have RARELY > had success treating this area for __any__ disease without addition > of an anti-yeast topical added to the mix. > Soooooo, if the occlusion of this area is accepted as the primary > difference between this spot and others on the skin, we can > alleviate this situation by circumcision.  Regardless of the > national anti-circ frenzy currently extant, the truth of the matter, > dermatologically, is that we see vastly more skin disease manifest > itself beneath an intact foreskin than we ever see in the circ’d > male.  Soooooooo, sometimes we are forced to recommend this. >>it would be tough for psoriasis to be >>"dry and scaly" in the instrinsically moist environment under a > foreskin. > Exactly correct. >>I’m wondering if you might not have some sort of allergy. > That has to be considered, but WAY down the list of differential > diagnoses. >>take a close look at any changes in soaps, personal lubricants, > sex partners, etc. that corresponded to the onset of this condition. > Yes, soap of any type, even Dove Unscented (the mildest soap in > history) can irritate, so it should be used __gently__ (the Dove, > that is), and rinsed well.  Other soaps are much more irritating, > such as the antibacterial soaps and __all__ the liquid soaps. > Let’s talk about sex a minute.  (Now that you’re listening!!)  This > is another crucial difference between this glans area and other body > areas.  And since we know that friction, through the mechanism we > call the Koebner phenomenon, activates psoriasis lesions, any and > all attempts to relieve friction are extremely important.  This > would include the use of condoms, and application of good lubricants > (KY Jelly [not the new liquid form]) heavily during sex. >>Try soaking at least once a day in a tepid or warm bath with NO > soap at all. > This can indeed help "dry" the area, if the foreskin can be easily > retracted, and water "sloshed" back and forth, or wafted over the > area.  A small container of water (beer stein for some, thimble for > others can be used.  Add __nothing__ to the water.  Never rub or > scrub this area intentionally, as suggested by LA2 in her note. >>Try to avoid the steroid cremes, as these can thin the skin and > make things worse, especially right after you stop using them, > causing a rebound flare effect. > More sage advice from "deputy dermie" LadyAndy2.  See more about > steroids, below. >>I think it was a natural excretion that she was producing > (subconsciously) to get even with me > Hogwash.  Exception? –> irritating vaginal product used, or one to > which he is allergic.  Rare occurrence, believe me. >>When I had my circumcision done it was soo painful, I couldn’t > walk for a year! > VERY exceptional.  In unresponsive patients who have had this > procedure, the results were good to excellent, and the areas healed > promptly without complications, except in the occasional patient > whose psoriasis worsens in the surgical site temporarily > (Koebnerization). >>circumcision as an adult is no laughing matter; don’t think about > the op as an early solution, cause it won’t be. > Not necessarily the truth at all. >>does she have a history of thrush or chlamydia > Extremely important, and excellent point.  Another –>  diabetes > makes candida (yeast infections) much easier to transmit.  Make sure > you are tested for this.  Partners often kick the yeast back and > forth between patient and unaffected individual. >>I was prescribed Locoid steroid cream by my derm. He almost > fainted at the news of me using such a strong steroid cream in that > area. > Wrong again.  If a steroid has to be temporarily used in the area, > Locoid is excellent because of its extremely mild character and lack > of flourination.  To wit, we use it in selected cases on the faces > of babies! > Well, I hope this little diatribe will help some guys out there.  My > office door is always open for questions.  Just set ‘em on my desk. > I’ll be right back.  ;-) > Dr. Joe

Response:

Great post Dr. Joe. Thanks again. How dare someone say you dodged the issue again. Tim

Response:

Michael very commen for someone to develop P after an injury or break to the skin,at the sight of the injury,simply because,in trying to heal that injured area,the body kinda overdoes it with the skincells.I have P on areas that I nicked while shaving,and even a couple from scratching a bug bite a little too hard,Iam more careful now. – Hide quoted text — Show quoted text ->I’m circumcised, so I am somewhat disqualified from comment. I do know, >however, that circumcision as an adult is no laughing matter; don’t think >about the op as an early solution, cause it won’t be. >You don’t mention whether you have a partner; if you do, does she have a >history of thrush or chlamydia or any of those nasty boogers? > It is very embarrassing but I suffer with p in that area (no foreskin). > I noticed in the thread the mention of various types of p. I’d totally > agree that the ’sensitive’ part actually sustains scales and the area of > the fold another type entirely. > I was prescribed Locoid steroid cream by my derm. When my normal doctor > found out he almost fainted at the news of me using such a strong > steroid cream in that area. The resolve of the matter was that the derm > said you only occasionally use a very small amount of gel and true > enough it clears for a few weeks. > Let me assure people that I’d happily exchange p in that area for a > large patch somewhere else!!! If you already suffer with p then you > should consider skin disorders that might look different as being just > another form of p. That area of the body is the most sensitive possible > to be infected and untreated will cause serious breaking of the skin so > medical advice *must* be taken. > A somewhat change of body location but recently I fell over and badly > grazed my knees. I was aghast to see that after healing the broken skin > changed to psoratic as did a scratch on my arm. > Michael > —

Response:

Dear Forum-ers: I’d like to do what I can to help with this difficult problem.  This will involve stepping on a few toes, but just hit <delete> if you wish.  No problem. Let’s take some statements made here, restate them, dissect them, and try to re-assemble the parts which are factual and add some suggestions. First, >The most probable diagnosis so far has been psoriasis (suggested by a biopsy >taken from the foreskin), but so far it hasn’t responded to cortosteroids or >other psoriasis treatments.

They teach us in residencies that if you need a biopsy to diagnose psoriasis, you’re probably too close to the problem.  Well, that’s only partially correct.  We use them in difficult areas such as the moist area under the foreskin to _help_ us confirm or reject a diagnosis.  Sir William Osler suggested to us, "Look for one disease," but in this area, there is rarely just one problem to be diagnosed and treated. Let’s look at what’s different about this tender spot, over other skin which may or may not show findings of psoriasis:  The skin is, in fact, more tender, thinner, wetter, more bacterially contaminated, more contaminated with yeasts, and much more susceptible to the complications of topical medicines than almost any other human body area. Most obvious of these differences is the simple fact that this prepuce area is a moist, dark, covered area.  This __GREATLY__ increases the chances that organisms will grow there.  I have RARELY had success treating this area for __any__ disease without addition of an anti-yeast topical added to the mix. Soooooo, if the occlusion of this area is accepted as the primary difference between this spot and others on the skin, we can alleviate this situation by circumcision.  Regardless of the national anti-circ frenzy currently extant, the truth of the matter, dermatologically, is that we see vastly more skin disease manifest itself beneath an intact foreskin than we ever see in the circ’d male.  Soooooooo, sometimes we are forced to recommend this. >it would be tough for psoriasis to be >"dry and scaly" in the instrinsically moist environment under a

foreskin. Exactly correct. >I’m wondering if you might not have some sort of allergy.

That has to be considered, but WAY down the list of differential diagnoses. >take a close look at any changes in soaps, personal lubricants,

sex partners, etc. that corresponded to the onset of this condition. Yes, soap of any type, even Dove Unscented (the mildest soap in history) can irritate, so it should be used __gently__ (the Dove, that is), and rinsed well.  Other soaps are much more irritating, such as the antibacterial soaps and __all__ the liquid soaps. Let’s talk about sex a minute.  (Now that you’re listening!!)  This is another crucial difference between this glans area and other body areas.  And since we know that friction, through the mechanism we call the Koebner phenomenon, activates psoriasis lesions, any and all attempts to relieve friction are extremely important.  This would include the use of condoms, and application of good lubricants (KY Jelly [not the new liquid form]) heavily during sex. >Try soaking at least once a day in a tepid or warm bath with NO

soap at all. This can indeed help "dry" the area, if the foreskin can be easily retracted, and water "sloshed" back and forth, or wafted over the area.  A small container of water (beer stein for some, thimble for others can be used.  Add __nothing__ to the water.  Never rub or scrub this area intentionally, as suggested by LA2 in her note. >Try to avoid the steroid cremes, as these can thin the skin and

make things worse, especially right after you stop using them, causing a rebound flare effect. More sage advice from "deputy dermie" LadyAndy2.  See more about steroids, below. >I think it was a natural excretion that she was producing

(subconsciously) to get even with me Hogwash.  Exception? –> irritating vaginal product used, or one to which he is allergic.  Rare occurrence, believe me. >When I had my circumcision done it was soo painful, I couldn’t

walk for a year! VERY exceptional.  In unresponsive patients who have had this procedure, the results were good to excellent, and the areas healed promptly without complications, except in the occasional patient whose psoriasis worsens in the surgical site temporarily (Koebnerization). >circumcision as an adult is no laughing matter; don’t think about

the op as an early solution, cause it won’t be. Not necessarily the truth at all. >does she have a history of thrush or chlamydia

Extremely important, and excellent point.  Another –>  diabetes makes candida (yeast infections) much easier to transmit.  Make sure you are tested for this.  Partners often kick the yeast back and forth between patient and unaffected individual. >I was prescribed Locoid steroid cream by my derm. He almost

fainted at the news of me using such a strong steroid cream in that area. Wrong again.  If a steroid has to be temporarily used in the area, Locoid is excellent because of its extremely mild character and lack of flourination.  To wit, we use it in selected cases on the faces of babies! Well, I hope this little diatribe will help some guys out there.  My office door is always open for questions.  Just set ‘em on my desk. I’ll be right back.  ;-) Dr. Joe

Response:

> BTW – I *do* have a sense of humor (I hope so anyway), but I see the >original >poster’s question as something to be taken seriously – not made light of.

I agree! When I had my circumcision done it was soo painful, I couldn’t walk for a year! Mark

Response:

I get psoriasis on my winkie every now and then…… I put some KY jelly on it. It sooth and cools…..  Im not a doctor but i know it works for me.

Response:

Hey,  I do not wish to be flip about your problem but I have to tell you I had a similar experience years ago.  I thought it was herpes and had all the tests done for STDs.   I was single at the time and had a few girl friends.  I discovered the problem only occurred after sex with this one particular girl.  I think it was a natural excretion that she was producing (subconsciously) to get even with me for not being totally faithful to her (which she suspected and which was true).  My solution:  I dropped her and the problem went away.

Response:

>Hey,  I do not wish to be flip about your problem

Hmmmmm, really?? >I had a similar experience years ago [snip] >I discovered the problem only occurred after sex >with this one particular girl.  I think it was a natural excretion >that she was producing (subconsciously) to get even with me for not >being totally faithful to her (which she suspected and which was >true).  My solution:  I dropped her and the problem went away.

OK – I have backspaced my (incredibly) sarcastic response in favor of a (mini) lecture. While it is possible for a woman’s vaginal secretions to irritate the penis of her SO, it is very unlikely that she was able to do this as a *revenge* response. It is more likely that she had a yeast infection or an STD. -Linda  BTW – I *do* have a sense of humor (I hope so anyway), but I see the original poster’s question as something to be taken seriously – not made light of.

Response:

> Hey,  I do not wish to be flip about your problem but I have to tell > you I had a similar experience years ago.  I thought it was herpes and > had all the tests done for STDs.   I was single at the time and had a > few girl friends.  I discovered the problem only occurred after sex > with this one particular girl.  I think it was a natural excretion > that she was producing (subconsciously) to get even with me for not > being totally faithful to her (which she suspected and which was > true).  My solution:  I dropped her and the problem went away.

  Maybe she was just trying to get even with yoy by putting toxic waste in her santch.

Response:

>I’m circumcised, so I am somewhat disqualified from comment. I do know, >however, that circumcision as an adult is no laughing matter; don’t think >about the op as an early solution, cause it won’t be. >You don’t mention whether you have a partner; if you do, does she have a >history of thrush or chlamydia or any of those nasty boogers?

It is very embarrassing but I suffer with p in that area (no foreskin). I noticed in the thread the mention of various types of p. I’d totally agree that the ’sensitive’ part actually sustains scales and the area of the fold another type entirely. I was prescribed Locoid steroid cream by my derm. When my normal doctor found out he almost fainted at the news of me using such a strong steroid cream in that area. The resolve of the matter was that the derm said you only occasionally use a very small amount of gel and true enough it clears for a few weeks. Let me assure people that I’d happily exchange p in that area for a large patch somewhere else!!! If you already suffer with p then you should consider skin disorders that might look different as being just another form of p. That area of the body is the most sensitive possible to be infected and untreated will cause serious breaking of the skin so medical advice *must* be taken. A somewhat change of body location but recently I fell over and badly grazed my knees. I was aghast to see that after healing the broken skin changed to psoratic as did a scratch on my arm. Michael —

Response:

>I get psoriasis on my winkie every now and then…… I put some KY jelly on >it. >It sooth and cools…..  Im not a doctor but i know it works for me.

Heck, KY is just a lubricant. It has no healing properties whatsoever. Just like using ultra skin conditioner it will just make the skin more subtle. If you are seriously saying that p appears in reality in that area and KY relieves it I’m sure many people would be interested in this. (Michael negotiates with the pharmacist for cut price tubes of KY <lol>) Michael —

Response:

Michael Iam sorry,and I know you have said before it isnt an STD,but this SO much sounds like a yeast infection that isnt healed properly,especially since you say it goes away and comes back.Since you are willing to try jsut about anything,and I dont know if this is available in the UK,but go to the pharmacy and hit the ladies section(you know what I mean) and get your self a tube of anti yeast cream,regularly used when women have a vaginal infection.It wont hurt and it might help – Hide quoted text — Show quoted text ->I get psoriasis on my winkie every now and then…… I put some KY jelly on >it. >It sooth and cools…..  Im not a doctor but i know it works for me. > Heck, KY is just a lubricant. It has no healing properties whatsoever. > Just like using ultra skin conditioner it will just make the skin more > subtle. If you are seriously saying that p appears in reality in that > area and KY relieves it I’m sure many people would be interested in > this. > (Michael negotiates with the pharmacist for cut price tubes of KY <lol>) > Michael > —

Response:

– Hide quoted text — Show quoted text -> I’ve had a persistent irritation on the glans of the penis for about 6 > months now.  It started with a very red & painful episode that lasted a > few > days.  The pain eventually subsided into a mild but constant discomfort > on > the glans, especially where the foreskin covers the head.  The symptoms > are > sensitivity, a burning sensation on the head that comes and goes > (usually > better in the morning then worse in the evening), excessive moisture > under > the foreskin that didn’t use to exist, and a slight "bumpiness" or > coarse > sandpaper-like texture of the foreskin that used to be smooth.  Two or > three > times the problem has flared severely into red, painful skin. > I’ve seen about a half-dozen doctors (2 urologists and 3 > dermatologists). > No tests have ever shown any signs of bacteria, fungal infection, or > STDs. > The most probable diagnosis so far has been psoriasis (suggested by a > biopsy > taken from the foreskin), but so far it hasn’t responded to > cortosteroids or > other psoriasis treatments. > Does this sound like psoriasis?  My understanding Is that it tends to be > more dry and scaly, not moist and bumpy? > Is it possible circumcision could help?  Could it be some type of > skin-to-skin allergy, since the irritation is most severe under the > foreskin?  I would hate to have an irreversible circumcision if it > simply > worsened the condition, but I’m getting desperate here.  I’ve also heard > sometimes surgery can make psoriasis worse. > Any information or similar experiences would be appreciated.

I’m circumcised, so I am somewhat disqualified from comment. I do know, however, that circumcision as an adult is no laughing matter; don’t think about the op as an early solution, cause it won’t be. You don’t mention whether you have a partner; if you do, does she have a history of thrush or chlamydia or any of those nasty boogers?

Response:

> Does this sound like psoriasis?  My understanding Is that it tends to be > more dry and scaly, not moist and bumpy?

I’m no doctor, but I’d guess that it would be tough for psoriasis to be "dry and scaly" in the instrinsically moist environment under a foreskin. I’m wondering if you might not have some sort of allergy. Have you consulted any allergists? You didn’t say how long you’ve had this problem, but it might be useful to take a close look at any changes in soaps, personal lubricants, sex partners, etc. that corresponded to the onset of this condition. > Is it possible circumcision could help?  Could it be some type of > skin-to-skin allergy, since the irritation is most severe under the > foreskin?

Well, circumcision would certainly eliminate the warm, moist environment under the foreskin. However, if you ARE suffering from psoriasis, you’d probably just be swapping the "moist and bumpy" for the "dry and scaly." >  I would hate to have an irreversible circumcision if it simply > worsened the condition, but I’m getting desperate here.

Absolutely! Especially if you’d prefer to KEEP your foreskin. Again, I’d keep specialist-hopping, and start including allergists in the mix. It’s when we’re confronted with off-the-beaten path medical conditions like yours that we come face-to-face with the stark reality that us humanoids still have a LOT to learn. Sometimes trial-and-error is our only recourse. Best of luck to you in finding a speedy resolution to your problem!

Response:

http://www.hkmj.org.hk/skin/balaniti.htm You  may want to visit this site and see if any of the descriptions of Balanitis fit your symptoms.

Response:

mukluks out of the cellophane before they scorched, dusted off the cornstarch, and put into writing the following ruminations: – Hide quoted text — Show quoted text ->I’ve had a persistent irritation on the glans of the penis for about 6 >months now.  It started with a very red & painful episode that lasted a few >days.  The pain eventually subsided into a mild but constant discomfort on >the glans, especially where the foreskin covers the head.  The symptoms are >sensitivity, a burning sensation on the head that comes and goes (usually >better in the morning then worse in the evening), excessive moisture under >the foreskin that didn’t use to exist, and a slight "bumpiness" or coarse >sandpaper-like texture of the foreskin that used to be smooth.  Two or three >times the problem has flared severely into red, painful skin. >I’ve seen about a half-dozen doctors (2 urologists and 3 dermatologists). >No tests have ever shown any signs of bacteria, fungal infection, or STDs. >The most probable diagnosis so far has been psoriasis (suggested by a biopsy >taken from the foreskin), but so far it hasn’t responded to cortosteroids or >other psoriasis treatments. >Does this sound like psoriasis?  My understanding Is that it tends to be >more dry and scaly, not moist and bumpy? >Is it possible circumcision could help?  Could it be some type of >skin-to-skin allergy, since the irritation is most severe under the >foreskin?  I would hate to have an irreversible circumcision if it simply >worsened the condition, but I’m getting desperate here.  I’ve also heard >sometimes surgery can make psoriasis worse. >Any information or similar experiences would be appreciated.

I’m not pro- or con- on circumcision, but I’d not have the surgery if I were you because of your aforementioned fear, which is often correct. – Hide quoted text — Show quoted text –

Response:

There are 5 different kinds of psoriasis.  The dry and scaly stuff is plaque psoriasis, the most common variety.  The kind you are describing sounds like inverse, which is the kind you get frequently in the areas that skin folds in on itself, such as the genital area. Try the National Psoriasis Foundation for more information on the 5 kinds of psoriasis and suggestions for treatment in this sensitive area. http://www.psoriasis.org/ A good first step would be to REFRAIN from using any soap at all there for a while.  Try to let the skin rest and calm down.  It may be flaring because you are scrubbing it too much and irritating it.  Try soaking at least once a day in a tepid or warm bath with NO soap at all.   When you get out and things are still moist, put some thick, soothing creme, such as Eucerin, on it to help it calm down.  Try to avoid the steroid cremes, as these can thin the skin and make things worse, especially right after you stop using them, causing a rebound flare effect. Hope that helps!  (Oh, and I would NOT consider surgery for this… like others have said, you have a very real potential of not only making things worse, but suffering other side effects of the surgery that you don’t want, such as loss of sensitivity.  And like you said, that is a one-way road that you should be wary of. ) You can read more about circumcision at: http://www.healthcentral.com      I understand there will be some special additional information posted there on the subject next week. Best regards,

Response:

> I’ve had a persistent irritation on the glans of the penis for about 6 > months now.

Is it possible that you have an allergic reaction?  Are you using any new washing products or lubricants?  Are you washing MORE now that you have the problem?  Is it possibly an allergy to latex (condoms) or even a lubricant packaged with the condom? We can even be allergic to laundry products including fabric softeners. It sounds like the right path to do the biopsy.  Many dermatolo- gists will prescribe some sort of steroid for about half of the problems they see just to see if the condition will respond. Frequently it does so we get cured not knowing what it really was.  (Nor does the doctor.)  It’s when it doesn’t respond, as in your case, that they have to do more specific tests.  Keep trying.  I agree it would be a shame to lose your foreskin especially if it’s blameless.  To me, it’s even more valuable than a tooth — and God knows how much trouble and expense I’ve had to go through to save two or three particular teeth. Regards,  Rick in Toronto

Response:

I’ve had a persistent irritation on the glans of the penis for about 6 months now.  It started with a very red & painful episode that lasted a few days.  The pain eventually subsided into a mild but constant discomfort on the glans, especially where the foreskin covers the head.  The symptoms are sensitivity, a burning sensation on the head that comes and goes (usually better in the morning then worse in the evening), excessive moisture under the foreskin that didn’t use to exist, and a slight "bumpiness" or coarse sandpaper-like texture of the foreskin that used to be smooth.  Two or three times the problem has flared severely into red, painful skin. I’ve seen about a half-dozen doctors (2 urologists and 3 dermatologists). No tests have ever shown any signs of bacteria, fungal infection, or STDs. The most probable diagnosis so far has been psoriasis (suggested by a biopsy taken from the foreskin), but so far it hasn’t responded to cortosteroids or other psoriasis treatments. Does this sound like psoriasis?  My understanding Is that it tends to be more dry and scaly, not moist and bumpy? Is it possible circumcision could help?  Could it be some type of skin-to-skin allergy, since the irritation is most severe under the foreskin?  I would hate to have an irreversible circumcision if it simply worsened the condition, but I’m getting desperate here.  I’ve also heard sometimes surgery can make psoriasis worse. Any information or similar experiences would be appreciated.

Response: