Rash near my goin

I am a male and I have had a skin rash on my inner leg near my groin. It has a mild itch and originally has very small bumps similar to poison ivy (but without the open ***** bumps I usually get with poison ivy). I went to a doctor about 6 weeks ago and she prescribed Benadryl and a steroid cream (Clobetasol Propoinate). I took both medications and the rash seemed to subside. Recently the rash has come back even bigger than before and the bumps are much bigger. I thought it may be jock itch and treated it with Lamisil AT for a week with no avail. The only thing that has affected the rash is the steroid cream. The cream gets rid of most of the itch and all of the redness, but the bumps are still there. As soon as I stop using the cream, the redness and itchiness of the rash comes right back.
There are a total of 5-6 bumps. The biggest is about 15mmx8mm and the smallest is about 4mm in diameter. They all feel hard underneath the skin and are raised 1-2mm. The whole rash covers an area about 3 inchesx1 inch. None of bumps hurt and there is no scaly-ness like I've seen in pictures of jock itch. The bumps don't appear to be in a small ring as in pictures I've seen of Granuloma Annulare. Also, there are no whiteheads or anything filled with puss that would lead me to believe it is a boil or anything like that.
I had the rash for 2-3 week before I went to the doctor the first time and during that period it did not seem to spread. The only thing that changed was the intensity of the itch.
My questions are:
What is causing this rash? Is it a fungus or bacterial infection?
Is it contagious? And what is the best way to treat it?

[Rohit Batra, MD]

Dear fjlevy,

The area you describe is known to get affected with Fungal infections and at times Fungal infections are resistant to topical therapy.

Bacterial infections are associated with pus discharge, pain and the infection spreads on application of topical steroids. So it does not seem to be bacterial infection in your case.

Frictional rub is another entity that is found in groin and is associated with vigorous exertion.

Steroids can change the picture of fungal infections and we call it Tinea Incognito. Repeated applications of steroids make a patch of fungal infection devoid of scaling.

I would consider giving a short course of oral antifungals with topical antifungals to see the response. Kindly consult your Dermatologist for a physical examination and prescription of Anti fungal medications.

Try to keep the involved area dry as far as possible.

Hope that this information helps and hope that you will get better soon.

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Best Regards
Dr. Rohit Batra