Question for Vanessa on Groin Pain

[scared_half_to_death]

Hi Vanessa,

I am having some strange symptoms...

a. Burning pain in my urethra and on the right side of my penis
b. Burning in the back of my thighs, outer thighs, inner thighs, scrotum, rectum, and buttocks
c. On one occasion my penis bled a small amount while erect

This has been going on for 4-5 months. The pain varies in intensity and location from day to day. I do not have problems urinating or any increase/decrease of pain during urination. There is no sexual dysfunction.

There are some additional symptoms which may or may not be related

1. I believe that before this started there was tingling in my thighs and some numbness in the tip of my penis
2. I had a rash on the back of both thighs about 6 in diameter above my knees. Diagnosed as contact dermatitis
3. Since this started, I have not had an appetite
4. My mouth burns occasionally (i.e. my tongue and inside my cheeks)
5. My taste buds have been red
6. I had some burning in my armpits and upper arms for approximately 1 week

I have had extensive testing:

1. General blood work - including thyroid, diabetes
2. STD -  including 3 HerpesSelect (HSV1+, HSV2-)
3. MRI of brain/spine
4. MS, Lyme Disease, Lupus
5. Heavy Metals

The only abnormalities during my testing were elevated CPK levels, i.e. 700s initially which retreated to 300s. Swollen lymph nodes in my groin.

I have received the following treatment: 2 weeks CiPro, Cymbalta (for neuropathy)

What could this be? What type of doctor should I see to find a solution? What tests should I request?

[scared_half_to_death]

Hi Vanessa,

The rash was only for 1 week and only affected the lower back of my thighs. The axilla was not involved in the rash. Burning in the axilla occured approximately 2 months after the initial rash.

I do not have any urinary tract symptoms except for occasional (but frequent almost daily) burning on the right side of my penis/scrotum and twitch/pin-***** like sensations in the head of my penis. This is not related to urination or ejaculation.

Vitamin Bs were all okay when tested.

What is BUN? It sounds like I should follow up with a urologist on:

- Kidneys; specifically BUN and Creatine levels
- Urine and prostate secretion cultures
- Possible skin cultures

Have you ever seen a similar presentation of symptoms? What were the causes of the closet semblances?

[Vanessa Lacuesta]

Hi,

Thanks for the thorough response.

You have been thoroughly assessed and most infectious agents have been ruled out.

How are your urinary symptoms ?

Are they still present?

The rash as it appears involve the intertriginous areas like the axilla and the groin. You have also mentioned that this rash initially presented after wearing wet jeans. A contact dermatitis and a fungal infection may be likely differentials.The burning sensation may be present in both conditions.You have also noted that they respond to steroid applications.

I suggest that a repeat urinalysis and a urine and prostatic secretion culture done so that an underying UTI or prostatic infection be ruled out. Culture from skin scrapings in the area of the rash may also help if this is applicable.The presence of palpable nodes in the groin suggests an infection.

Also ,were you able to have a complete blood count done as well as Vitamin B6 and B12 levels assessed?Your BUN and Creatinine levels may also be measured just to rule out an underlying kidney problem which may also present with rash and symptoms involving the mouth and taste sensations.

At this point,  I can not think of further modes of evaluation.

Keep us posted with regards to your progress.

[scared_half_to_death]

Hi Vanessa, I just wanted to "bump" the thread so that you would see it again. Thanks for your help.

[scared_half_to_death]

Couple of other comments...

1. Another major symptom is the abrupt loss of appetite. It can be described as a loss of the hunger sensation in my throat, but I still get the hunger sensation in my stomach. If I go a day or so without eating, I will feel hungry in my stomach, but not a pressing need to eat.

2. The rash seemed to spread to my perianal area initially, but there were no bumps there. This disappeared when the rash went away.

3. The groin pain may have developed a few weeks after the rash. I had a substantial amount of anxiety about this condition and cannot remember if the groin pain was immediate or not.

[scared_half_to_death]

Thanks for responding Vanessa.

I believe that the history is:

1. Tingling in thighs (however I cannot be sure that this came first. The rest of the history is definite.)
2. Rash
3. Groin
4. Axilla - Simultaneously there was slight tingling in lower legs. This and the Axilla issues have disappeared
5. Mouth

The rash was largely flat with some dispersed bumps (which seemed to be around hair follicles). It was red and very itchy, but not scaly. There was no pain even when touched. it was treated with steroid creme and disappeared within a week. There were no other lesions or rashes, except maybe a couple of small spots on either side of my inner thigh. I was in a hurry and wore wet jeans (just washed) out to meet a friend earlier during the day that the rash occurred. The dermatologist diagnosed it as contact dermatitis.

...answers to your other questions:

No joint pains or headaches
No flulike symptoms
No eye redness or visual symptoms
No surgery or instrumentation
No weakness
Palpable nodes occurred in the abdomen about 6 weeks after the start

The condition responded extremely well to Cymbalta. However, I will cease using it due to sexual side-effects that started to occur.

[Vanessa Lacuesta]

Hi,

Your primary symptoms involve burning pain in the groin,mouth and areas in the upper trunk.This is associated with a rash and increased CPK levels.

Let me ask a few questions just to clarify your post which is an otherwise good breakdown of your case:

Which of these symptoms came first? The rash or the burning pain?

Which one of these were affected first?

the groin
the mouth
the axilla

Also, how would you characterize the rash? Is this flat or elevated? Is this shiny or scaly? Is this reddish,bluish or skin colored? Is it itchy or painful?

Are there other lesions in the other parts of the body (scalp and navel)?

Any joint pains or headaches?

Any eye redness and visual symptoms?

Any fever or flulike symptoms prior to the onset of your symptoms?

Did you have a history of surgery or instrumentation before?

Any weakness in the extremities?

Any palpable nodes in the body?