How can a recurrent fixed drug eruption causing skin issues on my scrotum be treated?

Question

Hello doctor,

I experienced a fixed drug eruption three years ago due to fluconazole medication. I received treatment, which resolved the issue but left hyperpigmentation on my scrotum and penis. I mistakenly took a fluconazole tablet again, resulting in a recurrence of the same symptoms. This includes skin peeling on the scrotum and minor, round areas of skin discomfort and itching on the penis. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and will help you accordingly.

The differential diagnosis for your condition includes Sscrotal eczema, frictional dermatosis, or a possible allergic reaction to Fluconazole. I suggest you do the following to manage your symptoms:

Avoid known triggers.
Discontinue the drug that might be causing the eruption, in this case, Fluconazole.
Apply Aveeno moisturizer three to four times daily for 10 days.
Refrain from scratching or rubbing the affected areas.
Opt for loose, comfortable, and breathable cotton undergarments.
Prevent chronic friction in the affected area.
Maintain proper hygiene.
Use Cetrimide soap for bathing for the next month.
Keep an eye on your sugar levels.
Stress can be a significant contributing factor, so try to minimize stress.

I would like to gather some additional information to arrive at a definitive diagnosis:

Have you had a history of fungal infection in the past?
Are you experiencing itching or burning sensations?
Do the lesions appear as annular inflammatory (ring-shaped) rashes?

Kindly reply, and if possible, attach clinical images, as they would be valuable for further guidance.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

It seems to be a post-inflammatory hyperpigmentation scar with a secondary bacterial infection. I suggest you apply 2 percent Mupirocin cream twice daily for a duration of 10 days. It is important to avoid known triggers and refrain from self-medication. I strongly suggest getting the necessary blood work done, which includes a CBC (complete blood count), ESR (erythrocyte sedimentation rate), C-reactive protein, RFT (renal function test), and LFT (liver function test), and following up with the reports.

Thank you.