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Stubborn jock itch/tinea - what to do?

Stubborn jock itch/tinea - what to do?

I have been diagnosed with tinea, which has mostly cleared up with the exception of around my anus and up between my buttocks.  I have been using prescription ketoconazole 2% cream for 3 weeks and still have the condition.  A little background...

Last June, upon returning from Peru, I developed what I thought were rashes on my hip "pointers."  I attributed this to perhaps wearing the same shorts for several days in a humid (and dirty) environment.  It did not clear up using moisturizers, antibacterials, or topical over the counter antibiotics (Neosporin).  We also had just purchased new Washer/Dryer - thinking it may have been a reaction to the new High Efficiency (HE) detergent, we switched to unscented, non-dyed "free" detergent.  The condition persisted.

Later in the fall, I noticed what looked like a dry spot in the center of my right palm about the size of a half dollar.  This would occasionally be itchy, but mostly just looked like a patch of dry skin.

In January, I began working out and developed full blown jock itch.  At one point, it extended all the way my inner thighs almost to my knees.  Nothing on my scrotum or genitals.  I started using over the counter jock itch medications (Lotrimin and Lotrimin Ultra).  This cleared up after almost three weeks of treatment, however at about the same time I began getting an itchy anus.  As I also occasionally get hemorroids (hemorrhoids), I attributed it to that, but after a while developed bumps that are typical with tinea/jock itch.  I also developed what looked like acne on my buttocks and down the back of my legs.  This had not responded to the over the counter medications - and I tried several:  Lotrimin, Tinactin, Zeasorb powder.  My doctor then prescribed the ketoconazole.  After about three weeks, it seemed like it was subsiding, but I would also find myself scratching in the middle of the night.  It seems to be getting worse again despite continued use of the ketoconazole.

I have taken several other precautions such as using a separate, clean towel on my groin and buttocks.  I also never wear workout clothes more than once before washing.  I am still using the HE free detergents.  And I am still using the ketoconazole 2% twice daily.

Help!  Ideas?
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