A male patient of 35-years-old complains of severe itching around the groin, perineum, and around the inner thighs. Images are attached here. It looks like a fungal infection caused due to excess sweat and moisture. The patient has been using Hydrocortisone ointment and Itchguard without any improvement. He started using Clotrimazole ointment for the last two days with mild relief; however, he still complains of itching in the groin, especially at night. What could be the proper diagnosis and treatment? Any advice would be helpful.
It seems like funga infection (tinea cruris), however, I was also thinking of genital psoriasis too.
To my experience, terbinafin cream is an excellent choice in this case. While, I always alternate with antibiotic oitnment too (gentamycine + bacitracine or fusidic acid).
I use to prescribe oral antifungals (miconazole or terbinafin ) for at least 2 weeks, and anti-itching antihistamine for the first few days.
I hope your patient will get better in 2 weeks time. I always recommend re-evaluation.
Thanks for the response.
Patient wants to avoid any oral medications hence he is continuing to use Clotrimazole ointment with hydrocortisone and antihistamine tablets. However, his condition seems to be the same. He still gets itching at night and has to scratch inorder to get the relief.
I have attached a recent pic here for clear understanding.
Hello Dr,
as per my knowledge , let him continue the antifungal powder .in addition you can prescribe luliconazole twice a day for 1 week.convinse him for oral medication combination of itraconazole and terfendaminw for 1 week and evaluate after 15 days
Disclaimer: All medical case discussions published on this website are not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.