Burning, tingling thighs with near constant red bumps (2 years)

Dear Dr.,

I am 26-Male. For going on two years now I have had, with varying severity, almost constant burning and tingling thighs accompanied with a rash (always on the top inner thighs and buttocks).  The "rash" consists of red bumps about the size of a ballpoint pen tip which develop a little cream-colored blister/whitehead- they DO NOT have any pus like acne, etc.  A real oddity to me is that the bumps are always inside of a white oval/circle "patch" that is a bit larger than a pencil eraser.  

The "patch" that surrounds the bump has no other qualities other than the whitish color (I'm white- and the patch is whiter than my normal skin tone).  They have never hurt to touch, are always separated by an inch or so (never clusters), and seem to appear in different areas of the inner thigh and buttocks with no real rhyme or reason... I'll get 5-10 in various areas and they will just slowly dissapear in a week or so(no crusting, scaling, nothing).  To be clear- they will appear on the buttocks and thigh all at the same time.  After they dissapear- it starts all over again.  The thigh burning pain sensation never really leaves.

I have been living in agony- the main killer with this whole deal is the burning pain sensation on the inner thighs that is almost unbearable (it is not the pain/burn that chafing would cause).  I also get dull shooting pains in my buttocks and thighs which always seem to flare up before the bumps re-appear.

I had strong, consistant, dull testicle pain on and off with this for the past two years.  I saw a uroligist last month and, by way of a physical exam, diagnosed prostatitus.  I have been taking Cipro for that, for the past month and the dull pain in the testicles has gone almost all away- but the "rash" and burning has been the worst it's ever been... putting me at wits end.

Here are some items regarding my situation:

1.  I have not been sick at all in the past two years
2.  I have had no discharge of any kind
3.  This rash NEVER has affected the penis or testicles- only thigh and buttucks
4.  I smoke regularly
5.  I've never been diagnosed with an STD & always safe sex
6.  No fever, nothing painful other than thighs and the past groin pain
7.  I have noticed I bruise very easily now, have worsening flakes on scalp, moustache area, outer nostrils
8.  Fatigued alot (especially in the past few months)

Overall, this cycle has gotten far worse over the past 6 months.  I never go a day without burning thigh pain and seeing at least on blemish appear- while others fade.

I want so bad to have relief from this burning pain- i never have a rest!  One more thing- it seems to not phase me while I am asleep.  Within minutes of being awake it comes on hardcore!

What should I be checked for?  What would last so constant and steady for 2 years?  I just hope that you can lead me in the direction I need to go to find an answer to this hell.  Could this likely be an STD or something else?

Thanks so muc

[Alan Rockoff, MD]

Your rash does not remind me of any diseases I have seen or heard of.  People often get folliculitis in the area you describe, but that consists of pimples, not the kind of lesions you say you have, and does not burn.  These symptoms do not sound anything like herpes or any STD either.

It's not clear to me why you've never consulted a skin doctor, but I think you should.  Another possibility would be a neurologist, since inflammation of a superficial sensory nerve could give symptoms like burning (though not a rash.)  So I'd start with a dermatologist.

I will add one thing: if the skin doctor can't find a specific cause for the rash--or if the rash they do find doesn't explain the intensity of your symptoms--you will need to consider the possibility that much of what you're suffering from is psychologically-induced.  I quite often see patients who are, for one reason or another, worried about a particular area of their body complaining about tingling and burning in that area.  This may not sound plausible, but is nevertheless true, and you may need to consider it if you keep suffering as you have and no organic explanation can be found.

Good luck.

Dr. Rockoff

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