25 yr old male presented with itchy genital lesion for 6 months.h/o intermittent purulent discharge per urethra present


Sir, Multiple small dome shaped papules arranged circumferentially over the corona of the glans penis is a characteristic feature of pearly penile papules. As such, there is no known medical treatment that is effective. Surgical options are there, but usually not needed. And as you mentioned that there is itching, you may prescribe antihistamine. The other part of the question says, history of purulent discharge. Kindly rule out Gonorrhoea. You may advise Gram's stain (intracellular gram negative diplococci). Please work up the case.
How to differentiate from egw mam.

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BENIGN Pearly Penile Pappules undoubtedly
Pearly penile papules
PPP...Pearly Penile Papules Benign lesions, non contagious. Don't need any treatment for this at present. For purulent discharge per urethra. ..Ask for history of exposure. Advise VDRL, HIV. Treat it as gonococcal discharge or else send the specimen for HPE n treat accordingly. For itching. .antihistaminic
Belanitis. Check VDRL nd virals. RX. Atarax 25mg hs. Tab doxycillin 200mg bd tab fluca 150mg weekly , oint zole - f nd other ppi
Balanoposthitis Rx....antifungal drugs nd wash twice with warm water + salt in warm water with a cotton ball.
Tinea cruris, Balanitis.r/o Diabetes,c/s of urine.(Bact.urethritis)
Urine r&m and c&s Abstinance Antifungal oral and local
Belanitis. Check VDRL nd virals.
smegma is seen with balanitis
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