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Dr. Andrew Rynne

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Exp 50 years

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Skin irritation, red color skin, scaling of skin on groin, anus, buttocks. Had tinea barbae. Cure?

Answered by
Dr. P V S Prasad


Practicing since :1980

Answered : 254 Questions

Posted on Mon, 11 Feb 2013 in Skin Hair and Nails
Question: Mission objective: Be fully educated on my condition, and the possible next steps for treatment.
Reason for mission objective: I will visit a dermatologist again, but I want to familiarize myself with A) the condition, or possibly conditions that are affecting my body B) The possible treatments that will be considered

About me: I am not the person to research my condition and disagree with my doctor that has studied for many years and practiced in dermatology. I am an engineer and I need to understand WHAT and WHY. I can not simply take a drug or use an ointment without having a reason.
I want the dermatologist to say to me "Dan, you have condition X, we are going to treat it with Y, because of reason Z" The doctor that I first visited only provided the Y, the ointment, and left me in the dark on my condition and a reason for how the treatment will actually help me.

About my dermatologist: I moved further away from the original dermatologist that I originally visited. I am not opposed to visiting her again, but I now live in a metropolitan area, which has a wider variety of dermatologists.
Condition: Skin irritation, red color skin, scaling of skin. The areas affected are: groin, anus, buttocks, and possibly skin above my right eye and inner ear (I will explain why I used the term "possibly" further below).

Medical history on my condition: I went to a doctor that prescribed me Triamcinolon 0.1%. I used said drug as directed. The symptoms were reduced, but I now can say the symptoms are returning to prior levels. At the time, I also had tinea barbae. To my knowledge, that problem has been cured.

My Inner ear: I also have something going on in my inner ear. Skin flakes, skin irritation, fluid produced when itched.
My eye: There is also an area above my eye that gets EXTREMELY itchy and irritated (I say this because it's dissimilar to a normal itch that provokes a natural response to scratch, say on your arm).
Some extra stuff if you have the time to read it:
I wear jeans at work virtually every day. Originally when I had this problem, I wore a pair of jeans that was tight on my quads and groin. I have since purchased larger pairs. I feel that even the mere abrasiveness of XXXXXXX material can worsen the problem.

This also affects my ability to engage in my hobby of indoor rock climbing. A rock climbing harness keeps you safe by attaching a rope to a harness. The harness can cause excessive irritation of the issue. I have to take breaks from rock climbing in order for my condition to improve.

Please educate me. Could all of these conditions be related? Or are my eye and ear problems a separate issue (i.e. bacterial or fungal issue). Maybe it's that my eye simply hurts because I've been scratching it too much. I feel like the ear issue may be related, but would like to know if it is consistent with the condition.

What might the doctor prescribe me? How will it help me? Is my condition likely to be "cured" or will it be one that I will have to "deal with" throughout my life
Answered by Dr. P V S Prasad 7 hours later
Thanks for posting your query.
I appreciate for your detailed history.
From the history I could arrive at two possibilities.
1. Seborrhoeic dermatitis
2. Seborrohoeic psoriasis
Seborrhoeic dermatitis is an inflammatory condition which occurs in areas XXXXXXX in oil secreting glands in the human body. The cause is not exactly known except for few hypopthesis.
One of them is basically a fungal infection which when enters these special areas of the body, the body in turn tries to react with fungus and produces inflammation. It is like a war between two enemies. In the bargain damage to tissues happen and there is redness, scaling, pain and oozing which can be explained by the crying of humans when there is an injury.

The other diagnosis could be seborrohoeic psoriasis which also could occur in these areas. But this condition is also associated with scaling of scalp and scaly raised lesions on other parts of the body.

You have mentioned about tinea barbae. This could be a manifestation of seborrhoeic dermatitis. I don't think that we can make two different diagnosis in the same patient unless it exactly fits in.

the question is how to get rid of it and why should it recur?

I suggest that as it is basically due to inflammatory fungus it should be treated with
1. A course of anti fungals like Tab Fluconazole 150mg per week for 8 weeks
then, to suppress the inflammation
one may add topical steroids which your doctor has done
I beg to differ in this as topical steroids cause long term side effects and hence I would prefer an agent like tacrolimus or pimecrolimus which shows less side effects and which can be applied once or twice a day.

Can it recur?
Yes it can. This is usually a chronic condition and it definitely needs lifestyle modification
1. avoid too much sweating
2. Take bath twice a day
3. Avoid oil foods
4. Avoid fast foods
5. Avoid oil application to skin and oil massage

Can I correlate your exercises with this?
I cant say as it should produce only in the frictional areas and not on the face and inner ears. But as I said sweating could aggravate.

last please remember that most skin conditions including which I talked about could be worsened with stress and psychological disturbances. Hence avoid stress in life and resort to yoga etc.

I hope I have educated you enough.
If you still have any problem feel free to write to me again
have a nice week end
Prasad PVS
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. P V S Prasad 3 hours later
Oh my!

This was exactly the type of answer I was looking for!! Thank you for your timely response.

I was extremely worried about the integrity of this site after I paid my fee, while I was waiting for a response. I started google searching terms like "is WWW.WWWW.WW a scam?" I even read some poor reviews that made me worry even more.

If this is how the site always functions, I would have no problem offering a positive review of the website.

I actually do already practice yoga, but I have been slacking in my practice as of late. This will give me extra motivation to pursue relaxing asana sequences, which often benefit me the most. Probably wouldn't hurt to practice a little more pranayama and meditation either.

I can not thank you enough!
I just remembered one more question that I forgot to ask.

For the two conditions you listed. Are they transmissible during sexual acts, like "oral sex" or fellatio, or the typical vaginal-penal sexual intercourse?

I would like to truthfully inform any sexual partners about my condition when need be, or if questions are asked.

Thanks again.
Answered by Dr. P V S Prasad 52 minutes later
Thanks for your nice words.
I am happy that you are covinced.
For the next question
The answer in not at all
You can enjoy any type of sex which both of you enjoy
This is not infective to others even by skin to skin contact
Have a nice day
Prasad pvs
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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