Skin fungus on leg

I'm a 20 year old, Hispanic male. On January 10 of this year, I noticed a few small spots on my right inner thigh. Over the next few days they grew and looked almost like sores, so on January 13 I went to the doctor, where I was tested for gonorrhea and chlamydia, which both came back negative, and the doctor put me on lamisil, saying I had a fungal infection.

I started using the lamisil on the 15th, and for the next week everything seemed to be going fine, the spots turned brown and started to fade. Then on about the 24th I had a bad rash on my leg where the fungus was, and on my follow-up to the doctor on the 27th, he said I had a reaction to the lamisil, and prescribed me hydrocortisone steroid cream for the reaction.

I had some worries though, and so I didn't use it, and the next day, I went to see another doctor. I told her that the fungus was coming back, and I didn't want to use a steroid cream and make it worse. By this time, the fungus had jumped over a bit to my left thigh, as well as the rash. The three original fungus spots had combined into one, dark mass, and I had dry skin on both inner thighs, mostly on the original leg, which the doctor pointed out had spread along my thigh and started heading to my buttocks and genitals, but stopped short. She prescribed me a stronger topical medicine than lamisal, although the name escapes me right now.

I started using the new cream last night, the 30th. I put a little on my wrist to test for reactions, nothing happened. I applied it to my infection, and that night, I woke up with a severe itch on my legs. As directed, I still applied it in the morning, but the itching has continued, with my skin rash flaring up again.

My girlfriend has told me not to worry cause its the dry skin irritating me. I've has this infection for three weeks and I see the doc again on Friday. Should I stop using the cream, and what is wrong with me?  

[Bhupinder Kaur, MD]

Hello,
It can be due to due to fungal infection but chances are more likely that it is eczema. To confirm the diagnosis I suggest you to get a KOH examination and fungal culture of the skin scrapings done. A biopsy skin can also help in cliniching diagnosis. Treatment is different for both. While it is antifungals for the fungal infection, it is steroids and antihistaminics for the eczema.

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 dermatologist. Treatment can be started only when the diagnosis is confirmed. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.