Intense itchiness in the groin area

[Zebaz]

Hello Dr. Thank you for taking the time to answer my questions.

I developed intense itchiness on the left side of my groin. The first time it appeared was four months ago. It went away for a while then came back early this month. The intense itchiness in the groin continued and now it's on both sides of my groin. Initially it started as a raised wrinkled bump. It is the same color as the skin around it. There are no blisters or open sores. The area becomes inflamed and thick when scratched. In addition I get inner thigh muscle soreness and pain at times. I have seen an infectious disease doctor and RN; they seem to think it's some kind of fungal infection, tinea cruris. I've asked them whether this is herpes and they said it doesn't sound or look like it. The irritation seems to worsen when something rubs against it. I've been putting terbinafide cream on it two times a day. I have also tried clotrimazole without luck. I try to keep the area clean and dry with antifungal powder.


I'm currently on diflucan for a different infection....shouldn't tinea cruris be treated by this medication as well. If it's not fungal what is it?  Should I get tested for Herpes?
  

[Zebaz]

Hello Dr. Kaur,

It seems that the rash is getting worse.  I have used most of the over the counter anti-fungal products (tolnalftate, miconazole, clotrimazole) that you have mentioned for at least five weeks. None of them seem to help. The rash is not fungal because I have been on diflucan for over a year now.

The itchiness is intense when the skin are touching or there's something rubbing against it. What seem to, temporarily, help is the application of mentholated talcum to keep it dry.

I really want to see a dermatologist. Every general health practitioner and RN I have seen have not been helpful. What I need is a skin biopsy not a hydrocordisone cream to mask the underlying problem.  

The raised skin almost looks like molluscum contagiosum but there's no indentation or white waxy material in it. So I don't know. The bumps are not open or dry like warts. So it can't be herpes. Does herpes itch this much? They're very small and are not too big. It started on one side. Now they are appearing on both sides. What could this be?

I have taken pictures so you get a better understanding of how it looks.

1.) http://i1261.photobucket.com/albums/ii590/zebaas/035.jpg

2.) http://i1261.photobucket.com/albums/ii590/zebaas/011.jpg

3.) http://i1261.photobucket.com/albums/ii590/zebaas/040.jpg


Thanks for your help,

[Bhupinder Kaur, MD]

Hello,
This kind of rash can be due to fungal infection or eczema. Most cases respond to over-the-counter products, which contain any of several basic ingredients: miconazole, tolnaftate, terbinafine,ketaconazole and clotrimazole. You can consult a pharmacist and get any cream or lotion containing these ingredients. Some of them are Lamisil, Monistat derm, Mycelex, and Nizoral.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.