[29M] With recurring rash, swollen lymph nodes, and dental abscess

Patient Description

A 29-year-old male presents with a recurring rash on the shaft of his penis, described as red with very small bumps, making the skin look leathery if scratched excessively. The rash has occurred 2 or 3 times, lasting about 4-7 days with the use of dermatitis cream and avoiding scratching. The patient notes that smoking seems to worsen the rash, and he has recently stopped smoking after doing so for about 7 years. Additionally, he has noticed hard, non-tender swollen lymph nodes in the groin, right armpit, and neck for the past few months. Other symptoms include hives, dry skin, and dry eyes, with the dry skin appearing two-toned and leathery, particularly on the back of the thighs. The patient had a dental abscess that developed after a crown procedure, and the tooth was recently removed. He has not experienced any recent fever, chills, weight loss, night sweats, joint pain, or stiffness. There is no family history of autoimmune diseases, cancer, or other significant medical conditions, and he is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Recurring Rash on Penis Shaft

  • Contact Dermatitis: This could be due to an allergic reaction or irritation from substances like soaps, lotions, or even clothing materials. The leathery appearance and small bumps are consistent with chronic scratching and irritation.
  • Eczema: This is a chronic skin condition that can cause red, itchy, and inflamed skin. It can appear on various parts of the body, including the genital area.

Swollen Lymph Nodes

  • Infection: Swollen lymph nodes can be a sign of an infection somewhere in your body. Given your recent dental abscess, it's possible that the infection could have spread or caused a systemic response.
  • Lymphoma: Although less likely, persistent swollen lymph nodes can sometimes be a sign of a more serious condition like lymphoma, a type of blood cancer.

Hives, Dry Skin, and Eyes

  • Allergic Reaction: Hives are often caused by allergic reactions. Dry skin and eyes can also be related to allergies or environmental factors.
  • Autoimmune Conditions: Conditions like Sjogren's syndrome can cause dry eyes and skin, although this is less likely given your lack of other systemic symptoms.

Blood/Mucus/White Spots in Stool

  • Gastrointestinal Infection or Inflammation: The presence of blood or mucus in the stool can indicate an infection or inflammation in the gastrointestinal tract, such as colitis or a bacterial infection.

What you can do

Recurring Rash on Penis Shaft

  • Avoid Irritants: Try to identify and avoid any potential irritants, such as certain soaps, lotions, or fabrics.
  • Topical Treatments: Continue using the dermatitis cream as prescribed. Over-the-counter hydrocortisone cream may also help reduce inflammation and itching.
  • Hygiene: Maintain good hygiene but avoid over-washing the affected area, as this can worsen the irritation.

Swollen Lymph Nodes

  • Monitor: Keep an eye on the size and tenderness of the lymph nodes. If they continue to grow or become painful, seek medical attention.
  • Medical Consultation: Given the duration and hardness of the lymph nodes, it's important to consult a healthcare provider for further evaluation, which may include blood tests or imaging studies.

Hives, Dry Skin, and Eyes

  • Moisturize: Use a good quality moisturizer to keep your skin hydrated. For dry eyes, over-the-counter artificial tears can provide relief.
  • Antihistamines: Over-the-counter antihistamines like cetirizine (Zyrtec) or loratadine (Claritin) can help manage hives and allergic reactions.

Blood/Mucus/White Spots in Stool

  • Dietary Changes: Avoid foods that can irritate your gastrointestinal tract, such as spicy foods, alcohol, and caffeine.
  • Hydration: Drink plenty of fluids to stay hydrated.
  • Medical Consultation: It's important to consult a healthcare provider to rule out any serious gastrointestinal conditions.

What you should look out for

  • Persistent or Worsening Symptoms: If your symptoms persist or worsen, seek medical attention.
  • New Symptoms: Be vigilant for new symptoms such as unexplained weight loss, night sweats, or persistent fever.
  • Severe Reactions: If you experience severe allergic reactions, difficulty breathing, or swelling of the face and throat, seek emergency medical care immediately.

Remember, while I can provide information and suggestions, it's crucial to consult a healthcare provider for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago

People Also Ask


What could be causing the recurring rash on the penis shaft?

The recurring rash on the penis shaft could be due to contact dermatitis, which is an allergic reaction or irritation from substances like soaps or lotions, or eczema, a chronic skin condition causing red, itchy, and inflamed skin.


Why are my lymph nodes swollen and hard?

Swollen and hard lymph nodes can be a sign of an infection, possibly related to a recent dental abscess, or in less common cases, a more serious condition like lymphoma. It's important to monitor them and consult a healthcare provider if they persist.


What might be causing my hives, dry skin, and dry eyes?

Hives, dry skin, and dry eyes could be caused by allergic reactions or environmental factors. In some cases, they might be related to autoimmune conditions, although this is less likely without other systemic symptoms.


What should I do if I notice blood or mucus in my stool?

If you notice blood or mucus in your stool, it could indicate a gastrointestinal infection or inflammation. It's important to consult a healthcare provider to rule out serious conditions and consider dietary changes and staying hydrated.


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