What is the reason for the redness of the glans and the small spots visible after erection?

Patient's question:

Previously, there was erythema on the glans, and small spots were visible after erection, mainly distributed above the glans. They were not noticeable when not erect, but the skin had some fibrosis. The coronal sulcus of the glans and the ridge connecting it to the glans were slightly raised, meaning that part of the ridge was higher than usual. The elevated area was somewhat sensitive to friction.
Treatment history and effectiveness: Tried many similar medications like Terbinafine Hydrochloride, Ketoconazole, and potassium permanganate soaks, but none had any effect. It's not a recurring condition; it was completely ineffective.
I have also taken Itraconazole.
What help do I need: Since the medications didn't work, I want to ask if I misdiagnosed it—is it trichomoniasis or candidiasis of the glans? Additionally, if a hospital diagnosis is made, I would like to know...

Doctor's answer:

Hello, does your condition involve phimosis? Phimosis can also lead to the current situation. It is recommended to visit a large hospital's urology department for examination. The doctor should diagnose accurately and provide appropriate treatment. Currently, sexual activity should be avoided, and spicy or irritating foods should not be consumed.
The changes on your glans are likely pearly papules, which are caused by inflammation. It is advised to clean the glans thoroughly, use potassium permanganate for sitz baths, and apply erythromycin ointment. During treatment, sexual activity should be avoided. This is a manifestation of glans inflammation due to phimosis, requiring anti-inflammatory treatment.
Recommendations:
1. Use povidone-iodine to disinfect the glans and take oral antibiotics (levofloxacin) for treatment.
2. Avoid tight clothing and wash underwear with hot water and sunlight exposure.
3. Eat more vegetables and fruits, avoid spicy or irritating foods, reduce (avoid staying up late), and refrain from smoking, drinking alcohol, and excessive exercise. Maintain a regular diet, improve your immune system, and follow a healthy lifestyle.