Armpit and anus lichenified, flakey rashes

I have had two horrible itchy issues for many years now. One is under one armpit, which is an inflammed rash that has grown bigger over the years. It will fluctuate from normal to red and white, dry and flakey to very inflamed and weepy with cracks. It gets very painful and itchy. I have tryed an antifungal (with hydrocortisone), which helped initially. I continued to use it for about 3 weeks and it just came back once I stopped. Now I am using an anti-fungal powder and it looked like it was getting better, but has now become worse and it very flakey and dry with a weepy swollen red patch. The Dr told me to keep using it for 3 weeks so I will keep on with it, but it is very painful since using the powder so do not have much confidence it will work.
I also have something horrible going on around the anus and sometimes on the inner side of the labia majora. This will become very dry and wrinkly and crack, and will be so itchy. I was suggested to use steroid cream by the Dr who diagnosed me with lichen simplex chronicus - but so much use of it has weakened my skin and now I get piles so would love to find an alternative. I have read that lichen simplex is usually secondary to something and wonder what the underlying cause could be? Could the two conditions be related? They seem to become inflammed at the same time. Any suggestions would be much appreciated!

[Bhupinder Kaur, MD]

Hello,
From the symptoms it can be due to intertrigo or erythrasma. An intertrigo is an inflammation (rash) of the body folds. It most commonly occurs due to bacterial, viral or fungal infection. An intertrigo usually appears red and raw-looking, and may also itch, ooze, and be sore.

Erythrasma is a chronic superficial infection of the intertriginous areas of the skin. It is true that groins are effected but the typical appearance is well-demarcated, brown-red macular patches. The skin has a wrinkled appearance with fine scales.

It has to be differentiated from contact dermatitis, psoriasis, sweat dermatitis, intertrigo and fungal infections which may mimic it. Wood lamp examination and gram staining are the tests for its diagnosis.

So nothing can be confirmed without examination. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.