Rash in groin area

For about 3 or 4 weeks now I have had a rash in my groin.  It does not itch, burn, or sting. It is hot here, and I have been sweating a lot.  The area is in my groin fold, about half way between the pubic area and hip bone.  It does not extend onto my penis or scrotum.  It is in the crease of my groin, and when I sit down, this area makes contact with my upper inner thigh. I am a pretty big guy and it follows the ridge of fatty tissue that folds over when I sit down.   It is more or less linear. It looks like little red dots.  In the center it is concentrated so that area looks more red, and at the edges it kind of thins out.  It looks a little bit like razor burn.  It never blistered or ulcerated, just stayed kind of red.  It was about an inch wide and maybe 2 inches long when it was at its worst.

I thought it might be jock itch, so I  used lotrimin on it at first, then got some lotrisone and used that for about 2 weeks.  I stopped lotrisone about 5 days ago.  After the rash was present about a week, I took a dose of Diflucan 200 mg, and then a 2nd dose the following week.  

By about a week ago, the rash was totally, completely gone at that time and I looked normal.  Today, I look there and it seems to be coming back.  It is in the same exact place, but is less red and less wide than it was when it was at its peak.  It looks like a milder version of what I had before.  Still no other symptoms, just little red dots.

So, here are my questions:

What do you think this is?  Could it be partially treated jock itch?  Or maybe its a heat rash or chafing from sweating?  

Could it be something else or something more serious?

Could it be contagious?  Could I give it to my wife for example?

Should I continue anti fungals?

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum!

Based on your description, the first thing to investigate is intertrigo - inflammation of the body folds caused by skin friction (shafing), triggered and/or aggravated by heat and moist (especially sweat), and possible superimposed microbial infection (most often yeast infection). Intertrigo occurs more often among overweight individuals, patients with diabetes, or patients who are on bed rest; have to use diapers or medical devices. Underlying skin diseases can be inverse psoriasis, eczema, etc.

If infection is confirmed by laboratory tests (skin cultures), your physician will treat it with appropriate topical and/or peroral medication.  Theoretically, you can transmit that infection to your wife (contact of your affected skin with her micro injured skin).

If infection (bacterial, fungal, viral) is excluded, your dermatologist might recommend you to just eliminate risk factors and try a barrier repair type of product (often a zinc oxide product). Keep the area dry and exposed to the air to prevent relapses because they are possible and not rare.

Wishing You Optimal health,
Dr. Jasmina Jankicevic