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Rash on anus and scrotum, tried Clotrimazole, burning around anus. Is this an STD?

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Practicing since : 2004
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I am a 31 year old male, athletic, 5-10, 190lbs., and generally very healthy. I have had several unprotected sex partners in the past but have been in a monogamous relationship for 8 years. For a couple of years I have a recurring pink/red rash on my scrotum and back to my anus. It itches especially at night but less during the day. In the past I have noticed it in a very small location or two on the scrotum and cleared it up quickly with prescription steroid cream from a different doctor visit. That visit was for rash on my feet that seemed similiar to this one (diagnosed as contact dermititis). Currently, though the rash is spreading over my scrotum and area between it and my anus and I have tried clotrimazole cream for itching. It hasn't cleared any of the symptoms accept for itching temporarily. Its hard not to scratch sometimes and when i do frequently, the skin will scale and flake off. There is little or no pain associated with this rash unless I scratch too often. At which case it will slightly burn around my anus when taking a shower. No rash has appeared on my inner thigh. There is no pain or swelling in the testicles. I have been under a lot of stress lately and this ailment is adding stress. I sweat on a daily basis, but this does not feel like chaffing, which I have experienced in the past. There is no moisture around my groin after a shower, only during work ours. Is this likely an STD or could I try another medication before visiting a doctor?
Posted Sun, 29 Jul 2012 in Sexually Transmitted Diseases
Answered by Dr. Chakravarthy Mazumdar 21 hours later

I am a physician working in the Department of Venereology and I'd like to take this query today. I had gone through the pictures attached I hope I will be able to assist you better during our discussion here.

This is definitely not an STD is a simple answer to your question. Here are my scientific reasons:
1) STD is an acute condition cannot present after 8 yrs.
2) It is usually associated with body pains / discharge / lumps in the groin / fever
3) Monogamous relations is not a risk factor
4) The skin is involved not the area around the openings over the genitals

You probably have following conditions / factors:
1) Recurrence of contact dermatitis
2) A severe fungal infection
3) Lichenification because of chronic scratching (scaling and flaking with slight burning pain)
4) Stress

The following things help
1) You should see a doctor for medium potent steroid than the earlier one. Over the counter medications do not help from here.
2) Keep the nails short, it adds bacteria to the growing fungi
3) It also helps to treat anal itch with anti-helminths ( pin worm)
4) Keep the area dry with powder

Let me know if I missed any of your query.

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