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Have chronic rashes around anus and scrotum. Not cured by cortisone. What do you recommend?

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Dermatologist
Practicing since : 2005
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I have a chronic rash around the inner but cheeks close to my anus but not on it that goes to the base of the scrotum and also the other direction about 2 inches or so above my anus. I've tried cortisone creams, bacitracin, triple antibiotiics even desenex but no luck in it changing. I keep it the area very clean and a not XXXXXXX or involved in any anal sex. What do you recoommend?
Posted Thu, 11 Oct 2012 in Skin Hair and Nails
 
 
Answered by Dr. Sudarshan 1 hour later
Hi dear ,

Thanks for writing in.

The condition you are describing can be tinea carporis , scabies ,follicullitis ,eczema etc

Can you upload good quality photos of the affected area.

Also I would like to know-

Are any other parts involved?

Is the rash scaly?

Is there any symptom like pain/itching?

Is it raised bumpy or flat?

Does it have clear cut defined border?

Did it respond to cortisone?


Please answer the above questions and upload photo to help you better.

Regards
DrSudarshan
MD Dermatologist
Above answer was peer-reviewed by
 
Follow-up: Have chronic rashes around anus and scrotum. Not cured by cortisone. What do you recommend? 1 hour later
The condition you are describing can be tinea carporis , scabies ,follicullitis ,eczema etc
Can you upload good quality photos of the affected area. I would prefer not and also it is a hard area to take photos of by yourself.
Also I would like to know-Are any other parts involved? no. just the areas stated.
Is the rash scaly? no, it is usually smooth.
Is there any symptom like pain/itching? It does not bother me but it feels good to scratch it when I shower and sometimes there is a very small amount of bleeding that shows on my towel if I washed it with a wash cloth

Is it raised bumpy or flat? If it is bumpy,they are not very big bumps. The area at the base of my scrotum feels like it swells a tiny bit.
Does it have clear cut defined border? I am not certain but it is limited to within 2 or 3 inches of my anus. I had a stool test in March and had no parasites. I have had this for at least 8 months or more.

Did it respond to cortisone? A little but did not go away.

What should I do? Can I treat it with a variety of methods. I am also a dentist and could prescribe something for myself if you recommended it.






 
 
Answered by Dr. Sudarshan 4 hours later
Hi again,

Its good to know you are a doctor also.

As you know it is very difficult to predict the skin condition without having a visual clue.

As you have not uploaded photos I cannot pinpoint the diagnosis.

Most likely possibility in your case is a fungal infection that has got eczematized secondarily.

My recommendation in your case are-

Use oral antifungal like fluconazole tablet 150 mg twice a week.

Apply terbinafine cream twice daily.

Use clotrimazole powder after bathing.

Do this for 15 days.Then you can apply cortisone cream once a day along with terbinafine cream and clotrimazole powder.

Try to keep the area dry at most of the time.

Moisture and friction of body folds can lead to infection getting chronic.

Do not apply anything apart from what is suggested above.

Hope this helps.

I will be available for follow up.

Regards.
DrSudarshan



Above answer was peer-reviewed by
 
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