Rash and pain at tip of the penis

[RobertA22]

Hello Doctor,

I have an issue that has been going on for years.  The tip of my penis is red just around the urethra.  After mechanical irritation it gets worse and the rash looks scaly and tends to spread in star-like lines from the urethra towards the shaft (all restricted to the head of the penis).  When it gets really bad the rash will flake off and heal.  The redness is always there, but the severity changes.  

The other symptoms that I have accompanying this is a pain at the tip of my urethra and a tingling in the scrotum (my scrotum also gets very red at times).  These symptoms are felt daily.  I've been tested for every std and results have come back negative - other than HSV1 (I'm not sure if this manifested as cold sores as a kid).    

What skin conditions could cause such symptoms?  

[RobertA22]

I have been told that this could be dermatitis, but haven't found a way to treat it.  Is it possible that dermatitis at the tip of my penis could cause a tingling sensation in my scrotum and pain in the urethra?  

[Alan Rockoff, MD]

Probably no disease at all: just the way sensitive skin normally looks, perhaps aggravated by irritation and augmented by anxiety.  I assume you've discussed these symptoms with doctors in person.  If so, and if you've been told that you have nothing wrong, then you ought to consider counseling, because you may well have to come to terms with the fact that there's nothing in particular wrong, and that's the way your penis is going to look.  Once you accept that, I expect the pain will go away.

Best.

Dr. Rockoff