Itchy Scrotum

A few months ago I slept with a young lady from Europe.  A couple of weeks after our encounter I experienced a terrible case of jock itch on the underside of my scrotum.  I didn't connect the two events thinking it was just jock itch.  The condition presented with itching and rash (more from scratching than anything else) and no blisters or eruptions, though the rash did start at, and was worst in, a particular area about the size of a quarter.  I used terbinafine and miconazole OTC preparations and the condition seemed to go away.

I then slept with my girlfriend who later showed up with what her OB-GYN thought was a yeast infection, then genital HSV-1  (she now has no symptoms of either yeast or HSV, thank goodness, and her doctor says she does not have herpes).  Since my jock itch came back, I went at that point to an STD clinic, had an HIV test which was negative and a visual HSV exam and was told that I this itchy rash was not herpes.  I did not do lab tests for HSV or STDs other than HIV.  My family doctor prescribed a course of broad spectrum anti-biotic for STDs and this has not helped, nor did a ten-day course of of Nizoral for yeast.  Finally I have taken a therapeutic dosage of Acyclovir for two weeks to see if that would relieve my symptoms in case I had herpes (genital HSV-1).  It has not.  I still itch like the dickens down there and have a red, moist rash most days (more often than would be the case with herpes, so they tell me).  The itching is constant and the only thing that helps it is Lanacane.

I would like to see a dermatologist and get a conclusive diagnosis and treatment regime.  Can you please tell me which of the possible skin diseases you think I should be checked for and what kind of blood tests or cultures (skin scraping?) would give a definite on whether this might be genital HSV-1 or something else (I would like the precise names of the tests if at all possible, since I'm uninsured I want to avoid extraneous costs and expenses).  Lastly, if it turns out to be HSV that is causing the itch, could I really have no improvement with the anti-viral medication?  

The fact that oral and topical antibiotics, oral and topical anti-fungals and anti-viral medication have all failed to relieve the symptoms makes me think I my doctor and the STD clinician may have missed another, possibly less common, STD, or a dermatological condition that is common and which is not affected by the above drugs.  I look forward to hearing your advice on what you think I might have and you you think it should be diagnosed and treated.  Thanks.

[Alan Rockoff, MD]

I agree with the first part of the first sentence of your last paragraph, but offer a different ending:

"The fact that oral and topical antibiotics, oral and topical anti-fungals and anti-viral medication have all failed to relieve the symptoms makes me think I my doctor and the STD clinician may have missed" ---eczema, which commonly affects the scrotum, itches, and because it isn't any kind of infection of course doesn't respond to anti-infective treatments.

I suggest you stop all these creams, use only 1% hydrocortisone cream and a moisturizer like Vaseline, and show the dermatologist whatever is left, if anything, when you get an appointment.

Take care.  And practice safe sex if you're going to have sex with more than one partner.

Dr. Rockoff

[sickperson_india]

I have a problem with the scortum skin below my penis. It frequently gets scratched and appears red. The outermost layer of
skin appears to have come off.I find it very difficult to wear my underwear.Sometimes when i sweat a lot i feel a very itching sensation.
Is it a fungal infection. this problem has been there from 1 year.

[gt213]

hi just a few months ago i started to get this starnge rash on my scrotum and a little on my penis. i Havent had sex lately. the rash started to spread on different parts on my body. Please can u give me some advices as to what this is thank you.

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