instruction: hello doctor I am a 43 year old male I have spots and discomfort on the penis head it has been coming and going for a while now some of the spots are more visible if I squeeze the head and it looks like dark specks under the skin I am using butenafine hydrochloride and cortisone 1
output: hi reviewing your history and pictures showed there might be skin irritation which can be from repeated friction like masturbation or reaction to the substance used it also can be due to vitamin deficiency or a skin condition like psoriasis etc fungal infection is rare and it does not present as a spot usually it is whitish material and happens in people who are immune compromised like diabetics or people who have hiv infections since it is not itchy or painful you should not worry about it and you should not use cortisone cream as it makes things worse keep good hygiene area should be dry and clean use nonchemical lubricant like olive oil if you masturbate if you have changed your soap or shower gel it might be the cause take vitamin and vitamin a to replace your vitamin deficiency if you are known to have psoriasis then treatment can be by methoteraxate cream but only for people who are known to have psoriasis follow up is important and please keep me updated for any further queries