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Skin rashes on the inner thigh, burning sensation, shingles?

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Oncologist
Practicing since : 2002
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I have a rash on my inner thigh and am not sure what it is or how to clear it. It is not itchy, there are raised clear bumps, and it slightly burns. I can take a picture of it and send it to you.
Posted Sat, 14 Apr 2012 in Skin Rash
 
 
Answered by Dr. Robert Galamaga 4 hours later
Hello and thanks for the query,

This looks to me like a Bacterial infection. It can sometimes happen when bacteria get under the skin or inside the pores of skin. These rashes can sometimes be painful or itch and can ooze a clear or yellowish fluid.

I recommend you to apply Topical Antibiotic cream to the affected areas three to four times per day and keep a close eye on these lesions. If they expand significantly or you develop fever over 100 degrees F or shaking chills you should see your oral Antibiotic drug to clear the infection.

Finally, you could use some warm compresses with a clean hand towel twice per day on the affected areas. This can help open the pores and release some of the clogged material.

I hope this answer serves to be helpful and informative. If you have any additional followup query I would be happy to address them.

Sincerely,

Dr. Galamaga
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Follow-up: Skin rashes on the inner thigh, burning sensation, shingles? 2 hours later
Hi Dr. Quick follow up question: if this is a bacterial infection, is it contagious? And if so, how is it contagious? (ie: touch?)
 
 
Answered by Dr. Robert Galamaga 10 hours later
Hello,

Thanks for the followup query.

This is not something I would label as severely infectious but I would suggest to limit the close contacts and make sure you clean your hands after touching the lesion.

It is contagious if one of the blisters open up and the fluid oozes out which directly comes in the contact of someone else. It usually happens during sexual intercourse or through your infected hands.

It is not an airborne type of contagious disease.

I hope I have answered your query.

I will be available for further follow up queries if any.

Regards,

Dr. Galamaga
Above answer was peer-reviewed by
 
Follow-up: Skin rashes on the inner thigh, burning sensation, shingles? 26 hours later
Hi Doctor,

I wanted to get a second opinion so I went ahead and visited a dermatologist. He said he was 80% sure it was herpes. (I think general, non-genital) His primary reasoning was the cluster of blisters and the fact that it was on my inner thigh, couple inches away from my hip. I'm currently taking Valtrex two times a day as well as applying some topical anti-bacterial ointment.

I have a couple questions if you don't mind:
- What is your opinion on his assessment?
- I've been using Valtrex for a day now, the rash has gone away but the blisters/cysts are still there and are somewhat painful/bothersome. When will the blisters open up? Or how is it that these blisters will go away?

Thank you
 
 
Answered by Dr. Robert Galamaga 10 hours later
Hello and thank you for the follow up.

As far as the dermatologists conclusions I think this is possibly a very reasonable conclusion. In order to be absolutely sure of this conclusion a small culture can be taken off one of the areas of the skin. This is usually a very simple test which can be done with a cotton swab. You did not mention this in your follow up but I wonder if this was done by the dermatologist.

I am glad to hear that things seem to be getting better. If this is a herpes infection the blisters will certainly clear over time but it may take 7 to 10 days. Often times the will crust over with a covering. This will then slowly heal over time for a few days.

Sometimes skin infections can be challenging to diagnose and it may be difficult to distinguish a bacterial infection from a viral infection. Right now you are being treated for both possible causes and things seem to be getting better. Again I am curious to know if you had a viral culture taking all the area to confirm whether or not this is a herpes infection.

Again I thank you for submitting your question and follow up. Hopefully this will serve to be a very informative and helpful experience. If you have any additional concerns I am here for you.

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by
 
Follow-up: Skin rashes on the inner thigh, burning sensation, shingles? 17 hours later
Hi Dr.,

I had the choice of getting a biopsy or a cotton swab. The biopsy was $130 and I figured given that the dermatologist was 80% sure it was herpes, and it seemed like herpes, I passed on the biopsy. I do not know how much cotton swabs would cost. The dermatologist mentioned that the cotton swabs would be affected by sampling error and thus not as effective. Looking back I probably should have just gotten a cotton swab as I think it is cheaper.

I have uploaded the latest picture of the infection. Does this look more like herpes rather than a bacterial infection now?

All of yesterday and last night, the infection was very painful. I could not sleep properly as I kept waking up to the pain. This morning however, much of the pain subsided and I am hoping it only gets better from here.

At this point I am looking at the long-term. Being completely honest, I have no idea how I got this infection or why it suddenly broke out now. I have been going out with my current GF now for nearly 4 years. I am 100% sure it is completely monogamous and we are both each other's first real relationship. Our physical contact with other individuals before the relationship was limited. Basically, I've never done anything weird with anyone else and neither has she.

I would like to share with you what I know however, and get your opinion on any assessment you may have:
- My GF has what I think is called oral herpes. She broke out once a couple years ago with a small cold sore inside her lips. I think it is safe to say that I received the virus during this time. She has not had an outbreak since then.
- I started getting a red itchy rash this past Saturday night - Sunday morning. For the past 3 weeks during this time, I was particularly stressed from work and had not been working out as usual. I think it is fair to say my immune system was not the best during this time. But I definitely didn't feel particularly off or sick.
- Also on Saturday/Sunday, my girlfriend had a yeast infection in her vaginal area. I didn't make any physical contact with that area during this time. For the most part we were conscious about not physically touching.

Given the above, I still cannot figure out the following:
- Why an outbreak now
- Why on my inner thigh area

And lastly, I have some additional, more general questions:
- Is it possible for this infection to spread to other parts of my body and cause an infection there? (specifically the area I had in mind were my genitals as it is in such close proximity)
- Do you know if this is something I will have to live with for the rest of my life? Meaning, should I be expecting future outbreaks every couple times a year? Is there anything I can do to prevent future outbreaks?

Once again, thanks for your help and insight. Even if you are not sure of the answers, any knowledge will help. Ultimately if my condition does not improve or if I get a future outbreak I will probably re-seek out a dermatologist and really try to figure things out.
After I had typed up the above message, I realized that I just had to get this all figured out so I went back to my dermatologist. Upon looking at the infection, he was 90% certain that this was shingles. Still, I also opted for a biopsy and am awaiting the results.

While I'm not happy I have shingles, I am happy I don't have genital herpes. I am hoping this occurrence of shingles is a one time deal due to a lower immune system caused by physiological stress these past couple weeks. If I get another outbreak of shingles any time soon I may have to get my immune system checked. So just crossing my fingers. Additionally, given that the shingles is in a certain dermatomal on my body, the dermatologist said there was a low chance the shingles would spread to other parts of my body.

I do have a question though. Regarding postherpetic neuralgia, I know 20% of shingles patients get this after infection. I was wondering if you knew of any medication or procedures I can take now to reduce that percentage?

And lastly, regarding infecting others, my dermatologist mentioned that individuals who have already experienced chickenpox will be unaffected by my shingles. My girlfriend has not had chickenpox before but she might be immune to it given that she was exposed to it previously and had not developed any symptoms. Assuming she is in fact immune to chickenpox or that she has been vaccinated for chickenpox, will my shingles still affect her?

Thanks
 
 
Answered by Dr. Robert Galamaga 22 hours later
Hello again and thanks for the followups.

I am glad you went back to the dermatologist to get definite answers. The fact that you developed a significant degree of pain supports the diagnosis of shingles. This is caused by a varicella zoster virus as you probably know. It very likely developed in your case due to a perfect storm of circumstances including the stress you were under and the fact that your immune system was functioning at a less than optimal level. This definitely looks more like herpes now as I look at the latest photo you sent. Antivirals can sometimes shorten the duration of this. Regarding the pain it should level off and then slowly fade away. Post erosion neuralgia can sometimes develop and some studies support the use of prednisone along with antivirals to decrease neuralgia. Still this is not universally practiced and I generally have not given prednisone. Sometimes I do prescribe gabapentin to help relieve the nerve pain if it becomes severe. It sounds like in your case however the pain is lessening. Get plenty of rest, eat a well balanced diet and hydrate well and that will support a good resolution of the nerve inflammation.

I would not worry too much about recurrence of this although it is remotely possible moreso around times when you might be stressed or otherwise ill.

Regarding potential contagious activity with this related to your girlfriend - not something I would worry about. Most people are now immunized against chickenpox and your girlfriend should have been immunized as a child unless her parents refused it. Innyour case to be extra careful inwould make sure not to have her come in direct contact with the lesions for the time being.

Thanks again for the query. I hope this serves to be helpful and informative. Should you have additional concerns I would be happy to address them.

Sincerely,
Dr. Galamaga


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