I've tried Lotrimin AF and Ketoconazole-- Is this really ringworm?

Since mid-February, I have had this rash on my hand. It started out as a paper cut of some sort, which I thought was because of my dry skin during the winter, but it was itchy and I kept scratching it (stupidly). Soon enough, it got bigger, almost the size of a dime, and so I began to apply bacitracin (anti-biotic). I also called my dermatologist for an appointment, but the soonest she could see me is not until the end of May.

Thus, it got bigger and itchier, and it was not until I asked my psychiatrist on March 18 if he knew anything about this rash. The second he saw it, he knew it was ringworm or some type of fungal infection. He even phoned his son who is a dermatologist and I sent him a picture from my cell phone of the rash. Based on the small picture, he said it could be a fungal infection, lyme's disease, and 2 other things. So that day, I followed my psychiatrist's advice and bought an anti-fungal cream, Lotrimin AF. I even checked with the pharmacist there, to ask for her opinion. She, too, was sure it was ringworm. And for 2 weeks, I applied the Lotrimin twice a day, and no improvement.

Since I stopped the Lotrimin, I tried to simply keep the ringworm clean by dabbing hydrogen peroxide on it twice a day and taping a bandaid loosely on it. I thought it was starting to improve, but I decided to call my primary physician for an appointment in the first week of April. Perhaps she could prescribe something stronger than Lotrimin... and she did. She prescribed me ketoconazole, which I should apply 3 times a day for 2-4 weeks.

So here I am now: it has been 10 days since I started using the Ketoconazole. It has gotten bigger and now I see tiny red bubbles/pimples/or blisters popping up in the middle...

Is this really ringworm? Any help would be greatly appreciated.

March 18: http://bit.ly/cXGLnH
April 13, the 2nd day of using ketoconazole: http://bit.ly/ccAQTM
April 18: http://bit.ly/cVUY9W
April 19 (you can see the ring formation after cleaning it with hydrogen peroxide): http://bit.ly/9G38G1
April 19, again, under a different light: http://bit.ly/b8EbY4
April 20: http://bit.ly/cnWfoH
April 21: http://bit.ly/cLS2sS


This discussion is related to lump in perineum area.

[Bhupinder Kaur, MD]

Hello,
It can be ringworm or nummular dermatitis. Please keep the lesion open and do not apply any band aid. Keep your skin dry and do not share other people’s towels. Application of local antifungal cream(terbinafine, clotrimazole, econazole, ketoconazole, miconazole) and oral antifungal drugs are the mainstay of treatment.

You can consult a pharmacist and get any cream or lotion containing these ingredients. If the symptoms persist then please get it examined from a dermatologist as oral antifungals may be needed.

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.

[Bhupinder Kaur, MD]

Hello,
It can be ringworm or nummular dermatitis. Please keep the lesion open and do not apply any band aid. Keep your skin dry and do not share other people’s towels. Application of local antifungal cream(terbinafine, clotrimazole, econazole, ketoconazole, miconazole) and oral antifungal drugs are the mainstay of treatment.

You can consult a pharmacist and get any cream or lotion containing these ingredients. If the symptoms persist then please get it examined from a dermatologist as oral antifungals may be needed.

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.

[a42121]

Bhupinder Kaur, MD:

Thank you for your quick response. I will continue the ketoconazole and try not to cover the lesion as much as possible. However, I tape a loose napkin over it at night and when I am at class, to prevent the cream from smearing on my bedsheets and to prevent from spreading it to my colleagues.

I am still looking for another dermatologist, under my insurance, who can see me sooner. I will keep you posted.

Thanks again.

[a42121]

Bhupinder Kaur, MD:

Should I stop using the cream? I noticed today that the ooze from the blisters under the cream was forming a yellow-ish crust. In the past 3 days, it has been severely itchy; last night I had to take Benadryl. It is definitely getting bigger and tiny open sores have been forming in the middle. There are also a few tiny bubbles or bumps on the surrounding surface. They are very tiny, but I can feel them when I run my finger over.

Please help! I found a dermatologist who could see me on Sunday, but I need to know if I should stop applying the cream. On Monday, April 26, it will be 2 weeks since I began the cream.

Here is a picture from this morning: http://bit.ly/bzp1HI

[Seeker9063]

I had a similar problem on my leg.  I used creams for months and no help.  I went to the dermatologist and he took a culture and said there was no fungus so it must have been an atopic dermatis.  I used Hydrocortizone cream and it was gone overnight.  This is usually what happens when it flares up again.  

However, recently, I had a rash on my hand. I used Lamasil, Lotrimin and Lotrim ultra(same as lamasil) for weeks.  No help -- only seemed to get worse.  So I read online about bleach and tried it for a couple of days (without diluting it).  Needless to say the bleach brought it down very little, but gave me a nasty chemical burn and the bumps started spreading as well as the pain from the chemical burn.  However, as it started to heal it was the samething -- more bumps and now little ones popping up around my wrist.  

I may have been able to use hydrocortizone and it may have worked, but I did not want to use it on my hand because I wanted to find the cause.  

So, a while back I read on the internet about vinegar for an athletes feet(this is seperate from the issue I went to the dermatologist for)   and it worked great for me.  I soaked my feet in a gallon ziplock bag with enough white vinegar to cover the athletes feet about 20 mins a day for a few days.  I have not had athletes feet since.  (I also make sure I use slippers in the gym shower or I don't shower.  That is how I got the athletes feet.)

Finally, yesterday, I tried apple cider vinegar.  I took a ziplock bag and filled it enough to cover the rash on my hand and made sure it stayed covered with the apple cider vinegar for about 20 mins.  It stung, but I could see the bumps changing to white like after you take a bandaid off. I took my hand out the bag and the bumps were all white, but the rest of my skin was perfectly fine.  There was a little puss from those that I had scratched real bad, but they all started to get smaller.  I woke up in the middle of the night and they all started having brown spots like when a scab is developing and they are starting to dissappear.  I soaked it again this morning.  Left a vinegar smell on my hand, but it seems to be working.  I will keep you updated.

[Seeker9063]

Ok Everyone,
This is for anyone who is reading this post later.  
After I soaked it again, using the same batch of apple cider vinegar, the rash got worse.  It spread up my arm, it is around my belly.  It was crazy.  If you want to try the Apple Cider Vinegar approach, try using a fresh batch each time-- Don't reuse.  Not to say that it won't still happen, but atleast you can eliminate that as a cause.  

So I finally gave up and went to the dermatologist.  They simply looked at it and said the issue with my hand looks like a fungal infection and everything else was a result of shock to my body and probably triggered exzema (eczema) up my arm and etc.  They gave me a prescription for some inexpensive fungal pills (something with a Terban. . . same stuff in lamisil -- can't remember the name.) and a cream called Clobestal Proprionate(more expensive).  

It was tough the first couple of days seemed to do nothing, still itchy all over and now itching on my back, etc.  however, after a while the patch on my hand started pussing up and looked really nasty.  It seemed only to be spreading.  I did not use the cream, just the pills, so I went and got the cream.  
Needless to say after the applying the cream, it seems to have stopped swelling, but not gone away.  Still itchy all over, but the patch on my hand is looking much better.  

One thing I can definitely say is stay away frompure bleach!

[a42121]

Thanks for the update. I'm glad you saw a dermatologist and that it's looking better. Did they take a scraping to test whether it was a fungal infection?

It looks like the cream you were prescribed is a corticosteroid, which helps relieve swelling and itching. http://www.drugs.com/cons/clobetasol-propionate.html

Please let me know if/when it completely heals!

[jillay]

ask your doc for lotrisone. worked for me. in the meantime, stop by cvs and pick up some clotrimazole. i'm not a doctor, but i have been dealing with this since may and they are the only things that seem to work. i also tried ketoconazole but it just made it worse so i stopped it. i'm tellin you, that lotrisone (clotrimazole + betamethazone) was like magic.