Q. There is a large area of redness in my buttocks,is it psoriasis?

Answered by
Dr. Atishay Bukharia
and medically reviewed by iCliniq medical review team.
Published on Jun 27, 2015 and last reviewed on: Jun 14, 2019

Hello doctor,

For a couple of months, I have had a red area between my butt cheeks (not anus, further up where butt cheeks meet). This developed on the right side as a large area of redness which now feels scaly and a bit raised. At times it may feel moist, watery, not quite bleedy though. I tried an athlete's foot antifungal spray which I think helps a little bit, but it comes back again. Is it psoriasis or fungal infection or just irritation? I am a runner and sweat a lot due to heavy exercising every day. I took a picture, and I have attached it. Please advise.

Dr. Atishay Bukharia

Cosmetology Dermatology HIV/AIDS Specialist Plastic Surgery – Reconstructive And Cosmetic Venereology
#

Hi,

Welcome to icliniq.com.

After carefully reading your complaints and looking at your photographs, there seem to be three possibilities (attachment removed to protect patient identity).

  1. Tinea cruris.
  2. Psoriasis.
  3. Erythrasma.

For making a clear cut diagnosis, I need the answers for a few questions:

  1. What is your age?
  2. Which is the predominant symptom, itching, pain or burning sensation?
  3. Is it seen in any other site like elbow, knee, scalp, palm or soles?
  4. Any history of diabetes or any other medical problem?

Looking forward to your response in order to help you.

Thanks a lot for the quick answer.

Here is the additional information: I am a 33 year old male. The predominant symptom is itching. I would not say pain or burning sensation really, as it is not intense. The urge to scratch and continue scratching is present at night. No other site has such a problem. I have good skin overall. But I have some acne on the back and that is all. No other medical issue. I am in good health. As I had mentioned earlier, I exercise and sweat a lot. This area often feels "sweaty".

Does it look like a fungal infection? The clear symptom is that scaly patch, very clear demarcation between normal and affected skin. At times it may feel like leather and it is one of these "feel good scratch" that just, of course,makes it worse. I have used Lotrimin antifungal spray thinking I knew what it was. Applying the spray does it burn for a bit, but as soon as I stop using the spray I am back to the worse state. Can it be psoriasis or something else? If so would it mean that my body will have more of these patches? In any case, please let me know what you think it is and what you believe is an appropriate treatment. Thank you.

Dr. Atishay Bukharia

Cosmetology Dermatology HIV/AIDS Specialist Plastic Surgery – Reconstructive And Cosmetic Venereology
#

Hi,

Welcome back to icliniq.com.

Yes, you are right it is a fungal infection. Psoriasis will always present at other sites too and itching is not the predominant symptom in case of psoriasis. You are taking inadequate treatment that is why it is relapsing again and again. Moreover, you need to take oral antifungal medication in order to treat it properly.

The management is as follows:

  1. Tablet Sporanox (Itraconazole) 100mg twice daily for 10 days.
  2. Abzorb powder (Clotrimazole) to be applied to the affected area thrice daily.
  3. Tablet Levocetirizine 5mg twice daily for 10 days.
  4. Apply Lamisil cream (Terbinafine) on the affected area once daily at night.
  5. Try to keep the area by applying Abzorb powder and by wiping the sweat with a clean dry cloth.
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