Red, burning, pain (during walking) Scrotum

Two month ago, my upper right area of scrotum got small area of sting pain and itch.  I used antigal cream (Ketoconazole 1%+Fluocinolore 0.025%) with oral amoxycillin pill for ten days.  Initally, feeling good and color returned to normal.  On day 5-10, it came red and movement pain.  GP then gave Synalar cream (Fluocinolore 0.005%).  Color returned to normal, but shinning (scaly) with dry and pain developed over the scrotum bottom up to anal areas in further day 5. Movement caused spot skin casted off.  

Then, GP gave Lamisil (terbinafine hydrochloride 10mg/g) for 5 days.  I had 2 days break, and then GP gave resolve plus (miconazole nitrate 2%+hydrocortisone 0.5%) for further 5 days.  It caused my scrotum and anal area more burning, painful, dark red, crack, relaxation all the day.

I tried back antigal cream for further 7 days.  The normal skin color cannot returned, but only dark red, burning with pain, relaxation ( during walking and afternoon till night).  Sitting got worser. The scrotum pigment totally changed ......  Drak red during walking, pale color with relaxation during warm bathing.... pale and seem normal after cool water bath....

Now, applying only dry skin cream make myself feeling better.  Bedtime and morning is normal but only a little red on upper part of scrotum.  Walking and sitting still causes pain then returned to dark red with burning.  I need to apply dry skin cream 2-3hr times to cool it off with better feeling.  The cool weather days make me comfortable with less symptom.

What do you think it is ???????

By the way, I have taken many antibiotic during the past six months before having the scrotum skin problem.  Nothing was found by all doctors (GP, Infectious disease, Haematologist) , but only showed sinusitis and very weak immune system (CD4 at lower bound).  Several lump nodes around groin areas showed reactive lymphadenopathy in fine needle test on May 2010, but no more pain now in my lump nodes.

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum!

It is best you stopped with those multiple, (kind of random) treatments without even having a proper diagnosis. If applying an indifferent (non medicated) cream for dry skin makes all symptoms go, you could continue with it as long as needed. However, fungal infection should be excluded .

It is quite possible that what initially happened was reaction to one or more of oral antibiotics you had been taking for six months prior to development of that scrotal/anal lesion. Remaining change in color could be just a residue and should resolve in time. However, if discomfort (pain, burning, etc.) intensify instead of fading out, a consultation with an urologist is recommended.

Wishing You Optimal Health,
Dr. Jasmina Jankicevic

[Kelvinlo]

Hi Dr. Jasmina Jankicevic,

Thank you very much for your advice.  One last thing I want to ask.  Can I use only swab results to exclude fungal infection.  I got two negative results in continuous two weeks after stopped antifungal medicine cream. Thanks.

Wishes you all the best.

Kelvin

[Davidlatino]

Dear Doctor,

Sorry to write here, but I coudn't post you a question because the button of asking questions is not shown on my laptop.

I have 2 circles on my scrotum with deferent colors of my skin color. I saw this about 5 months ago. When I dont use any cream, it peels. And itch.

I shave my scrotum from time to time under the shower using the shampoo... So shaving might cause this? Or is it an eczema? or what else?