It could indeed be fungus, despite all the evidence not confirming it so far. (Sometimes this is referred to as Majocchi's granuloma.) Your dermatologist's explanation and plan are sensible. Fungus of the follicle shafts is tougher to treat, harder to culture, and may indeed require an oral form of therapy. Oral antifungal treatment (usually Lamisil) is easy and safe.
This is an annoying rather than serious condition. It should be curable completely, even after 6 months, and the skin color changes from the rash are likely to go away completely, even after all this time.
Best.
Dr. Rockoff
I had a very similar problem, always thought it to be an insect bite, but doctors don't think so... "Just eczema"... one perscribed a steroid cream and seemed to have no effect, until it started getting really red, then dark in the center... real infected. Now another doctor says steroid creams make these areas prone to infection... turned out to be MRSA and I was hospitalized for 3 days. After getting it cut open to drain and a month of "healing", the same thing happened on my opposite leg. This was also near an "old" itchy area (like 15 years old), with a lump from healed over scratching, that I was also applying steroid cream to. I knew what it was and started anti-biotics right away, and has almost healed now.
I find when I take a shower or work outside and get hot (for a very short period of time), these areas get real red and some other areas on my leg (and groin area) get red/splotchy looking, and a spot on my upper forhead gets real red. After cooldown, most of the redness goes away. I'm just real paranoid that something else is going to get infected. Doc says just keep putting lotion on it... and don't get hot. I live in Texas... good luck! I am "healthy" other that this problem and have had all the blood tests run.... any clue what is really causing this, or diet or treatment that migh make it go away eventually?