Chronic groin itch

[twinings]

I've been suffering from a chronic groin itch for about two years.  I had what was diagnosed via physician examination and a wood's lamp test as a fungal infection about two years ago, which had infected both sides of the groin and thigh.  I had a number of boils that were drained, took both oral and topical anti-fungals, and the infection cleared over approximately a two-month period.  Since that time, I haven't had a physical re-occurance of that nature, but do have chronic itchiness (almost daily) in the area, and get occasional redness (which appears as a red narrow patch in the fold of my left groin about 1 to 2 inches in length).  The itchiness is typically in the folds between the legs and torso/genitals, but I also get occassional itchiness in the area above the genital region.  I've been working with my primary physician, dermatologist and allergist to try to contain the itch, but haven't been successful for any period of time.  Oral and typical anti-fungals have temporary impact in reducing the itch, but it resurfaces within a few days to a week of finishing a round of treatment.  It's become both a physically and mentally degrading condition as the itchiness can be unbearable at times, usually worse at night, which greatly impacts my ability to sleep.  Regarding my physical characteristics, I'm a male, in his early thirties and in fairly decent physical shape.  Any advice or referral is strongly appreciated as I'm not sure where my next avenue for treatment is. Feel free to ask any questions that you might have as well.  Thanks in advance for your time.

[alexende]

A related discussion, chronic jock itch was started.

[twinings]

That's interesting.  My primary physician thought the original case might have been a hair follicle infection, but it was pretty broad in range in terms of infecting both sides of the groin and thighs (there was even one boil on my right hand and one on my left arm).  I've tried Cortaid in the past, which seems to help for a time, but the itching invariably returns.  I've also tried using no medication for extended multi-month periods of time to no avail as well.  I guess it could be a mental thing, but I'm typically pretty stable.  When I saw the dermatologist again last month, she agreed that there was no fungal infection, but didn't have much in the way of explanation outside of a form of dermatitis.  Assuming that it is dermatitis, are there any additional suggestions that you might have for relieving the itch or breaking the itch-scratch cycle?  Thanks again for your input.

[Alan Rockoff, MD]

Fungal infections don't come with boils and do not show up on a Wood's light examination, so I am skeptical of the original diagnosis.  In any case, any fungi that may have been there are now long gone.  Rashes in folds of skin are often irritation, chafing, or a form of psoriasis.  These are best treated with low-potency cortisone creams.  Such rashes are common and generally only mildly irritating; they don't by themselves keep people awake.  No chronic groin rashes I know of do that.  I therefore have a strong suspicion that the debilitating intensity of your itch has more to do with worrying that you have a chronic fungus than with the rash itself.  Learning definitively that you don't have fungus sounds like the place to start, and consulting a dermatologist (a different one if necessary) would be the best place to learn this.  Beyond that, the less active medication you use, the more likely you are to clear up.

Best.

Dr. Rockoff