Concern about Rash in Groin Area

[doba]

Thank you for your efforts on this forum.  I have already found a lot of helpful information.  On Oct. 16, 2011 I had unprotected sex with a new partner.  She is a teacher and special needs coordinator, in her early thirties.  About a week later I noticed a slightly-burning rash in the crease between my scrotum and thigh.  It formed a line, of little cracks about an inch long, right in the crease.  I went to a doctor, who quickly determined that it was not an STD (genital herpes was my concern) but a common fungal infection.  I was given a cream that reduced the rash to a bit of redness.  In late November I noticed, further up the groin crease, small pinkish red patches on either side of the crease, one near the scotum, and one on the inner thigh.  I applied anti-fungal cream there as well, and the redness went away, probably within a week.  

Then, in mid-December, I stopped using all creams and two small pinkish-red patches returned at the same place on the upper groin crease, with one near my scrotum forming a small white pimple. I noticed these pinkish-red patches develop where the groin and thigh-skin touch when sitting. I went to my family doctor, who said that it was an infected follicle.  He suggested a hot compress, which I did, but I also began applying clotrimazole cream again, which seemed to reduce the pinkness and the pimple within a week. Now, I have noticed a small pinkish-red patch (pencil eraser size), with a bit of a pimple I think, though just under the skin, in the same place on the groin crease on the other side.   I'm guessing this is simply a heat or sweat rash.  And I'm aware that I've been quite paranoid about this of late, but I would love to hear any feedback, as I was quite concerned that I had genital herpes, as I read that it can be mistaken for other conditions.

Thank you again for your time.

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.  I think I can help.

Even before reading the information that your doctor believed your rash was not STD related, that was already my thought as well -- based merely on the title of your question.  There are no STDs that typically cause skin rash in the groin.  Herpes doesn't often present with lesions in that location, and both the detailed location (in the crural fold, i.e. the crease between thigh and groin) and description of the rash are against herpes.  So are your other symptoms, such as the pimple of the scrotal skin.

The most common causes of crural fold rashes are irritation from skin moisture, superficial bacterial infections, yeast, and non-yeast fungal infections of the sort that also cause athletes foot and jock itch.  All these are more common in overweight persons, in whom the crural fold may be continually moist from sweat -- but certainly can also occur in slim individuals.  A number of other conditions also are possible.  And most dermatologic conditions that cause rash anywhere on the body sometimes can affect the genital area.  (Even when the penis itself is involved, most rashes are caused by non-STD problems.)

If the problem persists, continue to work with the doctor you have been seeing; or if it remains unresolved, consider seeing a dermatologist.  But from all you say, I think you can safely dismiss genital herpes or any other STD as the cause.

I hope this has helped.  Happy new year--  HHH, MD

[doba]

Thank you kindly for your prompt response.  Just to clarify, the first little pimple I had was on the right groin crease, near the scrotum.  The one I just discovered recently is on the left groin crease, in the same place as where the one on the right occurred: near the scrotum, quite close to where the lower groin meets the thigh.  But yes, I am  letting go of my STD worries!  Thank you for your feedback.  Happy New new year to you too.