Need urgent help with this recurring male genital itch

[troubled2010]

Hello

Due to a lot of reasons I have an extremely loose skin around genitals  (penis, scrotum etc). I am getting this recurring itch around the root of penis since last few months. Its not red or bothering but its deep seated as if I start scratching, I feel like doing it very strong. If I apply Gold Bond cream (hydrocortisone), it goes away for some time. But if I apply it for a day and then don't apply for a day, the itch becomes more strong. So when I start applying it, I have to apply it for 3-4 days. I don't think its ring worm etc. There are no signs - what it can be and is it contagious.(how to confirm all this ). Last year I had itching around groin but it used to be oozing skin once I scratch and also redness, but not anymore

[troubled2010]

I had fungal infections over last year and they were in groin. This one is not moist but gets if I really scratch. Is there possible home test I can do to diagnose it ?. Also even after scratching it doesn't get red but if I do too harsh, it gets bruised. Also it is equally happening in winters too. I am positive on home split test. But KOH I think also returns a lot false positive. What is best way of getting rid of all these infections (which now may be are systemic inside) other than creams and powders

[Bhupinder Kaur, MD]

Hello,
Since the lesion is moist so fungal infection can be a possibility and for ruling it out, you need to get a KOH examination of the skin scrapings done. If fungal infection is proved, then topical and oral antifungals may be needed. Fungal infections are contagious but dermatitis and eczema are not.

I hope it helps. Take care and regards.

[troubled2010]

Thanks a lot for your response. The only peculiar thing is that itch is only if I start scratching but after that it is too deep seated and strong. After scratching skin becomes a bit moist in patches or bruise. I don’t think it can be anything contagious like ring worm as it is equally occurring in winters. Can I go for any test to confirm?. Can dermatitis be contagious and in what way ?.

[Bhupinder Kaur, MD]

Hello,
since steroid creams is giving you relief, possibilities like eczema skin, contact dermatitis or atopic dermatitis need to be evaluated. Although steroids, are commonly used for the treatment of atopic dermatitis, there are certain other agents also which are used like immune modulator drugs e.g. tacrolimus. These are available in the form of ointments and tend to prevent the recurrence. You can discuss with your dermatologist regarding the right use.

There are certain other non-pharmacological measures which are equally important in treating atopic dermatitis. These are Lubricating the skin frequently, avoiding harsh soaps and cleansers, preventing scratching or rubbing whenever possible, protecting skin from excessive moisture, irritants, and rough clothing, maintaining a cool, stable temperature and consistent humidity levels, limiting exposure to dust, cigarette smoke, pollens, and animal dander & Recognizing and limiting emotional stress.

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.