Red burning scrotum

For 5 months now I've had a what i think is a fungal skin infection of the groin which started in my groin where my scrotum touches my inner leg the skin became dark and irritable so i started applying Lymarin cream....after a few days the skin looked clearer so i kept using cream but my skin the turned back to the way it was and seemed to get worse and also my scrotum became very red and hot felt like it was burning no itching just irritated and red.So over the weeks i have tried all creams on the market and they all seem to work in the 1st few days then whatever it is in my skin just keep coming back.I have been to see a Dermatologist 4 times and each time they give me creams and powders and say try that they have given me no diagnosis or explanation.So the latest things i have tried is a 2 week course of Itraconazole tablets of 200 mg a day and i'm using Kenacomb cream a Nystatin combo cream and again it worked fine at 1st but now today my scrotum feels very hot and is very red and there is also a red streak going up the shaft of my penis now from my scrotum the streak starts thick and thins out as it goes up.I'm at a total loss on what it is or how i can treat it any help or advice anyone.

[Bhupinder Kaur, MD]

Hello,

There are a few possibilities for this kind of rash.It can be a fungal infection(Tinea cruris)
Wash your groin daily and then dry thoroughly by pat drying,not rubbing. A hairdryer is useful if you have hairy groins.The damp groin is an ideal site for fungi to multiply.Also wear cotton underwears and change them twice a day 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.

But if the rash is not responding to the antifungals then other possibilities have to be probed. Other possibilities are xerotic eczema,senile pruritis,atopic dermatitis,contact dermatitis,parasitic infestations,diabetes and liver or kidney pathologies.

Treatment for all is entirely different.I feel that you should consult a dermatologist and get this rash assessed so that specific treatment(antifungals,antihistaminics or corticosteroids) can be started.

I hope that helps. Please do keep me posted on how you are doing or if you have any additional queries. Kind regards.