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Suggest remedy for itching in groin area

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
Practicing since : 2002
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Question
Doctor I have vigorous itching in my groin area for the last several months. I have applied ONABET-B cream but as long as I stop applying the cream the itching starts once again. Sometimes the itching starts on my palms, jaws, elbows and also the foot. I am struggling to control the itch through various medicines but nothing seems to help. I am yet to idenify any food allergy which is leading to it , but nothing seems to stand out as an allergen.
Posted Wed, 13 Aug 2014 in Skin Hair and Nails
 
 
Answered by Dr. Sanjay Kumar Kanodia 57 minutes later
Brief Answer:
Kindly send details & pictures

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for vigorous itching in groin area and I can make out a probable diagnosis of either "Intertrigo" (inflammation of the skin over testicles and folds) or "Tinea cruris" or simply saying fungal infection of the area.

To confirm the same I request you to please upload few good resolution pictures of the affected area so that I can analyze it better. Kindly send good resolution pictures focusing the area of concern which can be seen on higher magnification. For uploading the pictures you have a facility on the right side of the page or can send on:

YYYY@YYYY

with "attention:Dr Sanjay Kumar Kanodia"

The pictures will be confidential and will not be available for anyone else to see except me.

For the itching on rest of the body including palms, jaws, elbows and other places there could be multiple reasons including atopy, fungal infections or urticaria. In view to help you better kindly elaborate this part of itching in terms of :

- Since how long you have generalized itching over body.

- Any eruptions on body or redness.

- Any aggravating factors
.
Hope to hear soon from your side.

With regards,

Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by
 
Follow-up: Suggest remedy for itching in groin area 17 hours later
Doctor , I have uploaded the pictures on the email ID mentioned with a flag in the subject mentioning your name.

For the itching on rest of the body including palms, jaws, elbows and other places there could be multiple reasons including atopy, fungal infections or urticaria. In view to help you better kindly elaborate this part of itching in terms of :-

Since how long you have generalized itching over body.
Answer : Perhaps last 4-5 years or even longer perhaps. -

Any eruptions on body or redness.-
Answer : There are momentary eruptions (small dots ) only on the palm and fingers when they itch and they disappear after sometime. Normally applying some skin moisturizer helps to reduce the itching, but it comes back within a few days. I have not been able to identify the triggers for the itching to start. Sometimes hot humid weather could be the reason , sometimes it could be extreme dryness of the face. However in all cases (except the palms and fingers as mentioned above) there are no eruptions on the body and neither is there any redness in the area.

Any aggravating factors.
Answer : Hot humid weather , extreme dryness (although I do not have dandruff at all), continuous usage of socks on the foot. Apart from this I could not identify any other factor like foods, creams, any other external stimuli which aggravates this condition.


Hope to hear soon from your side.
 
 
Answered by Dr. Sanjay Kumar Kanodia 11 hours later
Brief Answer:
Fungal infection and intertrigo with Urticaria

Detailed Answer:
Hello,

Welcome again and thanks for posting important details with pictures.

After analyzing the pictures and correlating with your query it appears that you are suffering from fungal infection with mixed "intertrigo"( infection of the folds) at genital area.

Additionally you appear to be suffering form Urticaria or hives as a generalized itching over rest of the body.

To tell you about fungal infection and intertrigo first: Fungal infections are common type of infections which can affect anybody at any site. But more commonly it affects the areas which are more prone for moist areas (as in your case). More specifically these are related to the hygiene and environmental factors along with certain systemic complaints as in hormonal problem such as diabetes.

Due to moistness it leads to growth of fungus at moist testicle area. By repeated touching or by scratching the area it leads to more irritation and infection by other bacteria leading to Intertrigo.

For the betterment kindly follow the suggestion below:

- Wash your genital area with mild soap.

- If it is causing irritation then can do cold compression according to the weather condition.

- Keep your self away from hot and humid climate.

- Take two times bath.

- Wear cotton clothes and cotton undergarments to be changed two times a day. Do not wear any synthetic or tight garments.

- Do not sit continuously for long hours.

-Don't try to scratch or rub the area as can lead to further aggravation of the problem.

For the treatment part -

In my patients I suggest them to apply latest anti-fungal creams such as "Sertaconazole" or "Amorolfine " and take anti-fungal tablets according to medical advise.

I also suggest to take oral anti histamine like loratadine or levocetrizine two times a day under medial advise if there is moderate to severe itching is present.

I also suggest to go for your blood sugar check up as per your age factor.


Now for the other part of the problem which appears to be "urticaria": To tell you Medically - Our blood contains multiple type cells including red blood cells and white blood cells.

Specifically these white blood cells provide immunity to our body which are of further multiple types. Whenever anything in body is not suitable or offending to body then the number of white blood cells increases transiently.

Particularly these cells which increase are eosinophils and basophils which are also known as mast cells. These cells contain granules which have a specific chemical known as histamine. So as soon as any offending factors come in contact there is bursting of the mast cells. There fore this histamine is released and we experience variable degree of itching and the kind of bumps or itching which we can see in yourself.

Now the type of offending factor are innumerable including our food, environmental factors including temperature variation, heat, humidity, cold, dust and even simple of fragrances in air and multiple of other related things and very importantly stress too.

For the treatment part - it is quite simple and treated with drugs which inhibits the histamine release also known as Antihistamines. I myself prefer Loratadine (Alaspan or Lorfast) in my patients as it is very simple medicine without any side effects of sedation.

In my patients I start with 2-3 tablets/day, as soon as good effect is maintained then reduce to one to two in few weeks and then alternate days in next few weeks. Once there are no lesions/bumps for few weeks then taper off to 2-3 tablets per week for few months and then stop it.

In general urticaria may remain for few months to upto a year period but sometimes it may progress even longer than that too. In most of the cases as our immune system and body get adjusted to that particular offending factor so it then self subsides.

I hope these information will help you. If you have further queries I will be happy to help.

"Wish you good health and early recovery from the problem"

Regards,
Dr Sanjay Kumar Kanodia
MD- Dermatology & Sexually transmitted diseases
Above answer was peer-reviewed by
 
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