Suggest treatment for fungal infection between the groin folds?
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Hello... i am having a problem with a possible fungal infection. It started approx 3 weeks ago with what i thought was just jock itch, because i have had it before. After using an spray version of lomotrin spray (over the counter) it was starting to spread on the base of my penis. Just redness at first. I went into a local urgent care to get a Dr's opinion and he had prescribed me clotrimazole-betamethasone cream. I started using it twice a day like he said after a shower. At first I thought the area started to clear up but seemed like it came back and had a XXXXXXX sized red blotch on the right side of my penis (3 days after starting the cream) So this kinda freaked me out so i got in to see a dermatologist. At the time the area was just red and itched. So he had told me that the cream i had been using was to strong for that sensitive area. so he started me on an Econazole nitrate cream 1% and an anti-fungal powder. He also gave me a desonide .05% cream for my scrotum because it was very red. I have been using these things for approx 4 days now and is not healing very quick. I also had sex with my gf whom i had been with for the past year, but i had worn a condom and extra lube because would reduce any friction. The problem was after we had sex the area on the side of my penis was very swollen, and by the next morning looked like the top layer of skin had peeled off... Nothing itchs but the side of my penis is very sore. Soooooooo... I went back to the dermatologist and showed him what happend. All he said was that i should put aquafor on the site to help heal along with the other meds he had prescribed. I just want a 2nd opinion. I am 28 year old male and live a very healthy active lifestyle and is concerning me. I have been trying to abstain from sexual activity because it it just to uncomfortable. The dermatologist had said that it did not look like an STD and looked fungal in nature. Im going to try and get some pics to the best of my ability. Do you think there could be a type of bacterial infection instead of fungus as well, and how come its taking so long to heal because it has been like this a week?
Posted Sun, 2 Feb 2014 in Sexually Transmitted Diseases
Answered by Dr. Kakkar S. 2 hours later
Brief Answer: Fungal infection, Genital Herpes Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX Thanks for posting such clear pictures which leave little doubt if any in my mind. The fungal infection that you mentioned in between the groin folds is still very much there. If i was your treating doctor i would advice that you continue with econazole nitrate cream and anti-fungal dusting powder for another 3-4 weeks. I usually add an oral anti-fungal like fluconazole 150mg in my patients, once/weekly for 4-6 weeks for faster relief of symptoms. Coming to the lesion on the side of your penis. Clinically, it is a group of well defined erosions and it looks a classical case of Genital Herpes. The lesion is located towards the base of the penis, which happens when the front of penis is protected with a condom If i was treating you, i would have advised you an oral Antiviral like Acyclovir 400mg thrice daily for 5-7 days. An OTC topical antibacterial (2% mupirocin) would take care of any secondary bacterial infection. I would also want to get a few lab tests for STDs like HIV, VDRL, HSV ELISA. I would advice that you see a dermatologist for a prescription for these medicines and follow up with reports take care regards
Follow-up: Suggest treatment for fungal infection between the groin folds? 1 hour later
thank you for the quick response on the question... what i do not understand though is everything i had read about herpes states there is some sort of blistering that occurs before an open sore. And the two marks that were on the area did not begin with any blisters of any sort. I had asked the dermatologist if he thought it was herpes and he said no, but that the fungal infection caused the skin to be weak between the hair and the irritation along with the sexual activity could have caused that as well... what do you think?
Answered by Dr. Kakkar S. 6 hours later
Brief Answer: Classical Herpes it is, Start Antiviral Detailed Answer: hi. Not all the lesions start with vesicles OR i may say that you may not notice the vesicles because they rapidly rupture to form erosions. No, the grouped discrete erosions on the shaft is definitely not fungal infection. It is Herpes Genitalis. You can review with your dermatologist once more. take care regards