What is causing this?

[LjtMN]

I have a rash that has what looks like pimples in it. This rash is at the base of my penis and extends about an inch in all directions, except the scrotum or penis. I have a similar rash at the crease of my thighs. The edges of the rashes are VERY dry and flaky. Last summer, I had a few pimple-like bumps in my the pubic region, between my belly button and penis. These were VERY itchy. When I went into the doctor, she said it was folliculitis and gave me Cephalexin to make it go away faster. At this time, I got tested for all STD's and came up negative. About a month and a half later (September), they came back, and then the area around the base of my penis, and evenually extending upwards towards my belly button, was itching LIKE CRAZY! I thought I'd take a Bic to the region and shave it all, thinking that would help(stupid). It got very red and worse. I went into the doc again (a different one) and he gave me some cephalexin. The next morning I woke up and my testicles had swollen to almost the size of a softball. I spent 6 days in the hospital, getting IV unison.  This was at the beginning of October. After I got out, I was on Amoxicillin, which I had an allergic reaction to, so they put me on Levaquin. Everything cleared up, but about a 2-3 weeks later, I started getting some very itchy folliculitis again.  The doc put me on another 10 days of Levaquin. Things cleared up again, but the region was very dry, including my penis.  When I was in the hospital, my penis swelled up too, which the doc said was ok, just fluid moving around. Again, this was healed up. Anyway, the whole region was dry, including a portion of my penis. This region started to itch a bit, so I put some hydrocortisone 1% on it, and the next day it was redder, and the day after it swelled up really bad, with puss coming out. The doc put me on 2 more weeks of Levaquin, gave me Hydrocortisone Valerate for the itching and swelling on the penis, and gave me Clindamycin Topical gel for the folliculitis after the levaquin course was done. So, the infection in my penis went away, and has not come back. However, the pubic region started itching again, along with the area between my scrotum and thighs. So, I thought I'd put some of that hydrocortisone valerate on the pubic region, and the next day it developed a very red rash and itched like crazy again. I went back in, and the doc put me on 3 months of of Doxycycline 100mg, once a day and told me to set an appointment for a dermatologist. I can't get in until Feb. This was last Monday.  Now, over the course of the last week, the itching did die down, but this weekend it became a little more itchy, though I did get pretty loaded Fri. Also, the rash has seemed to get a little more flaky at the edges too.  Can I try a fungal medication OTC? Would it make things worse if it wasn't a fungal infection? When the doc looked at this lasttime, he said that b/w thighs could be fungal,but didn't think the pubic region was.Any ideas, advice, help?

[Alan Rockoff, MD]

I am flattered that you think I can make sense of this immensely detailed and complex history.  Unfortunately, I can't.

Here's what I can say:

1.  Your rash doesn't sound fungal in any sense.
2.  At least part of the complexity is all the different things your doctors and you have thrown at it.
3.  None of this sounds like any STD.

I therefore advise that you do absolutely nothing until you see the dermatologist.  Plain soap and water, a light moisturizer, perhaps powder after showering, and nothing else.

You may actually clear up and be able to cancel the appointment.  Mild folliculitis doesn't even need to be necessarily treated.

Best.

Dr. Rockoff