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Hello dear patients. Today we are going to review the case of crack on a man’s foreskin. A man came to us, he only had sexual contacts with his wife and he had no other sexual contacts. Without any apparent causes, as he didn’t have allergies before, cracks and reddenings on foreskin developed. They were accompanied by tenderness, itch and burning – you can see it on the picture. In the beginning he went to his dermatvenerologic dispensary at the place of living where a diagnosis of candidosis was set, no other diagnoses are usually set. Clotrimazol cream was prescribed externally, it only worsened such cracks, they started to burn harder, they increased in size and after being disappointed he came to us. No analyses for candidosis were taken, then he came to our clinic. Preliminarily we advised him to use ointments and he did that by the visit to a doctor. Then we took analyses from the surface of these rashes for candida – the one that had to be taken initially, culture test for bacteria and candida and analyses from inside the canal and externally, for sexually transmitted infections. We took analyses only for the main infections as there’s no need to check for HPV for example as it doesn’t relate to such cracks. All sexually transmitted infections, including candida were negative, bacteria were also within norm. After that, analyses for allergy were taken – you can watch a separate video on our channel about what it is. Eosinophilic cationic protein was increased and also, it has to be said that analyses were taken for sugar and glycated hemoglobin that were normal. This rash is a toxicoallergic reaction where eosinophilic cationic protein is increased. This may be due to different irritants. Why does it localize on penis for the first time? That’s usually because the skin is quite thin, irritable and often, manifestations of it on penis are the only symptom of such reactions. By the way, eosinophilic cationic protein was increased threefold to normal. Here, during such an index, the treatment is quite long. Patients, coming to us, want a fast treatment – they want some ointment to be used and leave. Here, when toxicoallergic reaction goes, a vicious circle is formed – he was consulted by immunologist etc. and together with what immunologist prescribed, we prescribed sodium thiosulfate intravenously, calcium gluconate intramuscularly. Immunologist also prescribed hormonal medications in short courses. We also prescribed different softening medications such as rodevit and videstim. External hormonal ointments here have to be prescribed with great caution because in our videos we have several times showed erosions from hormonal ointments. Here it’s particularly dangerous as cracks are there already and it's easy for them to be formed to erosions. Here we may try such cream as elidel and it was done – this is a non-hormonal anti-inflammatory cream etc. So, here, the therapy is quite long-term for getting out of this situation - it took about a month in our case. The patients often do not understand that – as they were prescribed some magic ointments and they wonder why they don’t get out completely healthy. Unfortunately, allergy can be acute and there may be toxicoallergic reactions, including the ones on sexual organs, that manifest for a long time. It’s good that the patient wasn't using hormonal creams for a long time as this can happen quite often. This all resolved not earlier than 5 weeks – that was the time required for complete resolution of such process. So, here, injections have to be done for quite a long time and observation is needed etc. - so, in some cases, such skin rashes on genitals have a chronic course and I’m not one hundred percent sure that circumcision etc. would help somehow in the beginning, urologists do not perform circumcision until inflammation is not completely gone – the one that we see in the basis of such cracks as it’s not completely clear how they are going to heal. So, such toxicoallergic reactions are quite common on sexual organs and in some cases they have a very resistant course. If it is necessary to diagnose and treat any rashes in the area of sexual organs, you can consult dermatovenerologists and venerologists of our paid medical center of dermatovenerologic dispensary in Moscow. We have experienced specialists who do diagnostics and treatment of such rashes. We are waiting for you in our clinic, please subscribe to our channels on youtube and instagram. Thank you for your attention. ⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️ DVD dermato-venerologic dispensary is a specialized institution that provides medical care on dermatology, venerology, urology, gynecology and other specialties.