Welcome to the Dermatology Expert Forum!
Perianal rash can be caused by microbial infection (bacterial, fungal, viral), allergic contact dermatitis, irritant contact dermatitis, allergy to systemic drugs, lichen sclerosus & atrophicus, etc. Detailed medical history needs to be taken by a physician! Although often present, pain and/or itch are not mandatory subjective symptoms of perianal rashes.
If fungal infection clinically seems like most probable cause, that should be confirmed by laboratory test (skin culture) and then treated by an antifungal cream such as clotrimazole, ketoconazole, etc (without topical corticosteroids).
Light brown color of once inflamed lesion is most likely post inflammatory hyperpigmentation. It should subside in several weeks.
Wishing You Optimal Health,
Dr. Jasmina Jankicevic
My dermatologist has given me EC/HC cream Econazole Nitrate 1%/ Hydrocortisone 1%.
do doctors have differing opinions on the use of cortico steroids? he hasnt done a culture. he just looked at it and gave me the cream. he's a reputable doctor in downtown chicago. do you think i should go get a second opinion? do you know of any doctors in the chicago area who wont just take a quick look and make assumptions? i want to get a culture and i really dont like what i read about steroids.