Trying to Diagnose Rash In Groin Area

[regretful27]

About four weeks ago after horseback riding I noticed a small abbraision about 3/8 inch in diameter in the fold of my skin on the left side of my groin.  I started applying corn starch powder daily to help keep the area dry.  The abbraision didn't heal and actually expanded.  Additionally, I started to break out with bumps in the fold of my groin above and below the original abbraision.  The bumps start out as hard white or red bumps.  After a couple of days, the skin around the bumps begins chaffe and flake.  The bump then goes away leaving a pealed area of open skin.  The bumps don't produce any fluid or bleeding.  The skin is a little raw and red at first, but then tends to dry.  What is left are what looks like spots where a layer of skin has peeled away.  After bathing, the skin in the peeled area is noticably red.  

The original abbraision has peeled and grown to about 1/2 inch wide and 1 1/12 inches long.  The other spots are spread out about two inches above and 1 1/2 inches below the main abbraision.  They start out as pimple size and end up about 1/8 to 1/4 in diameter.  For the last five days I've been washing the area with selenium sulfide shampoo and applying Miconozole Nitrate powder spray twice a day.  The spreading of the rash seems to have slowed down, but the areas with the peeling don't seem to be healing, especially the main one.  The main abbraision does get raw and will crack a little bit as I move throughout the day.

I do feel a burning and irritation where the rash is.  I also have a general burning feeling in both sides of my groin that goes down toward my rectum and on the very upper part of my inner thighs.  There is no rash on my right side.

I've looked on-line and my symptoms seem like they could be Tinea Cruris or a Candida rash, but it doesn't look exactly like the pictures I see on the internet.  I'm wondering if I shoud continue my current treatment or this is something that warrants a visit to my GP.

[Bharat Chawda, MD]

Dear regretful27,

I would recommend that you take a course of an oral antibiotic along with an oral anti fungal. Among the various anti fungal, I usually prefer to use fluconazole (weekly) or terbinafin (daily) tablets for my patients. These medicines need to be continued for a month. Please consult a doctor to get an appropriate preparation prescribed for you.

You can also use mupirocin ointment over the lesion. This would help reduce the burning sensation.

Hope I've answered your query.  Wish you good health.

Best Regards
Dr. Bharat Chawda.

[regretful27]

I do not have much itching, it is generally a burning sensation and moderate pain

[Bharat Chawda, MD]

Dear regretful27,

You have provided a very good description of your skin problem. I appreciate it. From the information that you provide, there could be two possible reasons for your rashes.

1. Fungal infection (Tinea cruris)
2. Post traumatic inflammatory lesion

I could help you better if I knew how bad is the itching in the affected area. Would you say that you have more pain than itching?

In cases such as yours, I would prefer giving a course of antifungal tablets and an oral antibiotic which would take care of both the infections simultaneously. So to answer your question, Yes, I do think that you should see your GP. The medicines that I mention can only be prescribed after a clinical examination. Complete resolution of a fungal infections may take a few weeks. So do not worry and adhere to the treatment suggested by your doctor.

Hope that this information helps and hope that you will get better soon.

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Best Regards,
Dr. Bharat Chawda