Blotchy areas, upper thighs - how best to diagnose and treat?

[JimmyG]

Hello,
About 2 years ago I had a really bad case of jock itch,during summer time as I recall.The area in question, is at the very upper thighs where the crease of my legs enter the pelvic/pubic region.  I had at that time scratched the area to alleviate the itch, by the end of the week the area no longer bothered me however on both thighs there was a noticeable patch of skin about 2 in x 1 in that was darker and inflammed.  I had thought with time this area would regain its normal color but never has.  

Since then that area has never bothered me or been inflammed due to jock itch or any other affliction.  I don't ever touch the area for fear of the patches getting larger than they are.

Until recently I had not attempted to do anything about these areas, I began using a product, Porcelana from a local drug store
designed to fade dark spots.  The coloration of the areas before use of the product were a light shade of brown.  After about a week of use, the areas are now more of a peach/pinkish tone more
closely matching but still quite darker than the rest of my skin.

Am hoping for advice on whether I should continue use of Porcelana..of concern is that I notice when applying the cream it makes the regions a darker peach color which might be that my
skin is being irritated by it..(not certain).  

Also hope for any ideas/advice on what the problem might be...this has persisted for some time and I never do anything other than what I have done recently to treat these two areas.

Thanks much.

[Alan Rockoff, MD]

When inflamed rashes go away, they often leave brown discoloration that lasts for a long time, as in months.  Fade creams don't usually do much to accelerate the fading process.  In your case, the cream may actually be irritating you a bit, which would delay fading, so perhaps it's better not ti use it.  As to the pigmentation itself, of it persists more than a few months, you can have a skin doctor check it out, but if the infection is in fact long gone and the brown color stays, you might just have to live with it....

Best.

Dr. Rockoff

[JimmyG]

Thanks for the information..distressing.  I researched a bit, found a similar article posted back in 2002 on this same message board/ http://www.medhelp.org/forums/dermatology/messages/31622.html

Anyhow the patient's description is similar to mine, is it possible this problem could be at all diagnosed as a case of 'pityriasis versicolor' or perhaps
'tinea versicolor'?

Just searching for a bit of hope to properly diagnose and treat if at all possible.

The idea that I'm stuck with the situation is not at all one I want to accept - perhaps I will as you suggest go to see a specialist sometime in the future (as finances allow).

I am hoping that I might be able to try using a topical ointment
of some kind that might allow these patches of skin to heal over time?

Thanks for your time and expertise.

[Alan Rockoff, MD]

Tinea versiclor affects the back and chest.

I think a visit to a dermatologist is a good idea.

Dr. Rockoff

[JimmyG]

Hi Doc,

Interesting however after the initial irritation, apparently the Porcelana cream that I had described using worked!  I actually only used the cream for 3 days and apparently the irritation and reddening of the areas seems to be due to an active ingredient - apparently there was some type of bacteria/fungal infection that was the problem.  The areas are now blending in nicely with the rest of my skin...any ideas what might have been the problem?

And more importantly, should I go back to continue using Porcelana?

Like I said this has been a long time problem..over at least a years' time.  Treating the area with Porcelana acted as a medical application apparently.  I guess i should look more closely of the active ingredients of Porcelana skin lightening cream.

Thanks much for any input you might be able to add.

[Alan Rockoff, MD]

Porcelana has 2% hydroquinone, which is  skin lightener.  I'm glad it worked.  I guess you can still use it, but if the skin color is now even, I'm not sure why.  

The reddening would have been due to irritation, though, not bacteria.

Dr. Rockoff