Concluded Case

28 yrs M married before 15 days itching this type of lesions start after intercourse but increase after masturbation with help of cloth wife has no any symptoms consult to other local doctor treated with tab antiviral & multivitamins & steroid cream for LA Plz Dx n Rx

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Concluded answer

Dr. Ram Golde... Don't diagnose straightly...... Here visual shows multiple vesicles and pustules around coronal sulcus and glans area. Total rim of the coro al area is involved with inflammation and serous discharge. History is insufficient... Important points are.. Duration of appearing lesions after intercourse.... Painful or not Inguinal lymph nodes involvement.. Matted or discrete. To exclude.... Herpes by Tzank smear Chancroid...by Giemsa stain KOH test to exclude fungal involvement... Routine tests for genital lesions... VDRL test HCV test HIV screening... Here already patient took treatment outside. So the typical features of the disease proper is totally masked. First exclude the above diesase one by one will get final conclusion.

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Dr. Ram Golde... Don't diagnose straightly...... Here visual shows multiple vesicles and pustules around coronal sulcus and glans area. Total rim of the coro al area is involved with inflammation and serous discharge. History is insufficient... Important points are.. Duration of appearing lesions after intercourse.... Painful or not Inguinal lymph nodes involvement.. Matted or discrete. To exclude.... Herpes by Tzank smear Chancroid...by Giemsa stain KOH test to exclude fungal involvement... Routine tests for genital lesions... VDRL test HCV test HIV screening... Here already patient took treatment outside. So the typical features of the disease proper is totally masked. First exclude the above diesase one by one will get final conclusion.

I agreed with answer of Dr.P.K.Kumar.
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Clinical provisional diagnosis: Herpes progenitalis Desired history: •    Duration of disease-If it is more than 72 hours, it is NOT worth using antiviral drugs •    Premarital exposure: Yes or No (It is unlikely to be No).               If yes: Since when and last exposure Aim of clinician: •    Treat the patient •    Protect the wife from Herpes by advising them toavoid sex till lesions completely heal •    Sub clinical infection is possible •    To start Antiviral drug on day one in case wife manifests the herpes vulvovaginitis •    To investigate patient for any associated STD like HIV, Hepatitis B, Hepatitis C etc. This couple have started their married life with one bad card. But I am sure Dr Ram will manage them well and will protect their married life. Wishing them wonderful married life.

Thank you doctor
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IT'S A CASE OF.. * HERPES GENITALIS.. * YEAST INFECTION.. BETTER TO DO.. BLOOD.. URINE ROUTINE.. VDRL.. TRIDOT.. MEANWHILE TREAT WITH.. SYMPTOMATICALLY..AND.. ABSTINENCE..

Tnx
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Yes it is herpes progenalis it looks pt has exposure before marriage as penis looks to be circumcisised if i am not seeing wrong present vesicular lesions are aggravated with friction of cloth while masturbated Rx tab acyclovir or valcycolovir for 7days than tapper off and keep on maintenance for couple of months . Since pt had intercourse with wife give her prophylactic rx also

Thanx dr Rajesh Yadav
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?Genital herpes ? syphilis Get VDRL done Is he having fever? Pain And burning over the eruptions? Since when he's having the lesions? Pre marital intercourse history? Rest for INVESTIGATIONS part agreed with @Dr. P.kishore Kumar

Herpes genetalis Thrush penile with erythema seen Need some investigation of blood nd Management as per dd

Don't use steroid cream and stop it as it may aggravate the condition .A case of herpes progenitalis. Tab .Acyclovir 400 mg t.d.s for 7 days and topical neosporin ointment for any secondary infection

Herpes genitalis 200 mg acylovir 5 times a day 5 days oint acylovir 5 times

contact non venereal balanitis. wife needs to be treated as she is the hidden source. tt for both azee 1 GM stat flucanazole 450 stat to both plus tindazole to both treat the lady c candid v 6 inserted and hygiene

Herpes genitalis, acyclovir 400 mg tid, Acyclovir oint, antibiotics, Antioxidants, abstinence till cure partner treatment.screen for HIV & diabetes

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