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Fungal infection in crotch, perineum, ringworm, using anti fungal body wash, spray, open sores, negative HSV 2. Skin irritation or herpes ?

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I have had a persistent fungal infection in my crotch and perineum for years now. It was diagnosed by a Dr. as ringworm. (it presents as reddish brownish lines that follow the boundary of my legs to my crotch and converge in a generally red area in the perineum, which was also perpetually hairy and moist. I was told to use over the counter cream and medicated powder to treat it. It has, however, proven intransigent, at least in part because I would occasionally get tried of putting products on it consistently and it seemed fairly harmless. Just recently, I bought an anit-fungal body wash (Fungi-Cure) resolved to kill it once and for all. I was applying it pretty consistently (twice a day) as directed and spraying on an anti-fungal spray power upon drying and before getting dressed. It was working pretty spectacularly until I maybe started to overdo it (I rub this area really hard when I apply the soap and leave it on for a while) and the area began to hurt more consistently. Specifically, I noticed that sometimes it would sting for a second when I would spray the powder into my perineum. Two weeks ago, I tried looking at the area to see what the pain was. I thought I saw an open sore. Later that night, I re-examined the area and saw no sore, just some of the skin being shinier than others (something I've seen for a while with the fungal infection of the perineum skin). I concluded I must have been mistaken earlier. I was, as of 2010 negative for HSV 2 and have only had protected sex since. My last (protected) sexual encounter was in May.

Having said all that, I continued feeling the pain so I trimmed my perineum hair and used a mirror to look at it. I do see what look like open sores in places where the red lines from the fungal infection get back into the perineum. The sores are definitely in straight lines. Could it be the result of irritated skin due to the fungicure, or does it sound like I’ve got a mild case of herpes?
Posted Mon, 30 Apr 2012 in Skin Hair and Nails
Answered by Dr. Bharat Chawda 2 hours later

Thank you for posting the query.

You have provided with good information regarding your skin problem. I appreciate it.

It seems that you have a fungal infection of groins (known as TINEA CRURIS), and you are not responding good to the topical creams or the body wash which you are using.

There are times that one catches a resistant variety of fungal infection and thus doesn't respond to topical preparations. Also if one has diabetes, then he may not respond to creams or body wash. In such cases one would require a oral anti fungal preparation like Fluconazole or Terbinafin etc.This needs to be taken for at-least a month for complete recovery.

I would suggest you to consult a competent Dermatologist for physical examination, evaluation and to get the oral anti fungal prescribed to you by them. Usually these medicines are not available over the counter (OTC).

The open sore which you say must be because of the rubbing mechanism or friction associated with when one walks. It can also be due to the powder used leading to dryness. And its pretty normal to have pain over the area as there is a breach in the skin .You can use any topical antibiotic preparation over the lesion like Mupirocin oint/cream for few days. This would probably take 3-4 days to heal.

With the history you have provided, it doesn't seems to be a Herpes infection.

Hope I've answered your query. But if you have any further questions, kindly write back to us. I'll be available for your follow up questions as well.


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