What is the reason for red spots when the foreskin is retracted?

Patient's question:

The foreskin has red spots, about the size of a coin. What could be the reason?
Never had sexual intercourse. 23 years old. Is it caused by heat?

Doctor's answer:

It should be the symptoms of balanitis, which refers to the inflammation of the inner foreskin and the glans penis. A lipoidal substance normally secreted in the normal foreskin cavity can accumulate as smegma in cases of phimosis or excessive foreskin, stimulating the foreskin and glans penis to cause balanitis. The basic principle of Western medicine treatment is anti-inflammatory and antibacterial. Generally, it involves both topical and systemic treatment. For acute superficial balanitis and annular erosive balanitis, erythromycin and tetracycline are the first-line treatments. For trichomoniasis balanitis, metronidazole is the first-line treatment. For candidal balanitis caused by Candida, griseofulvin or itraconazole is commonly used.

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