Do chronic itching and burning of the scrotum that does not subside with antifungals suggest scrotal dermatitis?

Question

Hello doctor,

I am a 31-year-old married male. For the last ten years, I have had an itching and burning sensation on my scrotum that increases at night. It is also more during winter. I consulted a dermatologist who diagnosed it as Tinea incognito after I told him that I get relief with cream Mometasone Furoate 0.1 % and tablet Teczine. He has prescribed antifungal medications for two months (Itraconazole, tablet Bilastine, Luliconazole, Pacroma creams, and a moisturizer). The symptoms reduced but started again after stopping the medication. I observed that only cream Pacroma was giving relief. I am using it with Elovera cream and Physiogel in the morning and night after a bath. Also, I am using Cetaphil soap on the affected area. It is working only temporarily. Also, Pacroma cream and the tablet Bilastine are not working at times.

I feel it is scrotal dermatitis and not a fungal infection, as even two months of antifungals have not helped. The symptoms are reducing only with immunosuppressants. Also, I have read online that prolonged use of steroids is not good for sensitive skin and makes it thin. Is there a permanent cure for my problem, as it is also affecting my quality of life and sleep?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I reviewed your photos (attachment removed to protect the patient's identity). It is scrotal dermatitis. Due to chronic itching, scrotal skin has become thick. Scrotal dermatitis can occur due to multiple causes like atopic dermatitis, allergy to irritants, and many more. I suggest you get a patch test to rule out any allergic causes.

I also suggest the following tips and treatment:

Use loose cotton underwear.
Do not wear tight jeans for a few months.
Try to keep the area dry by avoiding sweating, so try to stay in a cool place.
Use Olesoft max moisturizer (Liquid Paraffin and white, soft Paraffin) two to three times daily.
Absorb powder (Clotrimazole) two to three times daily.
Tablet Levocet 5 mg (Levocetirizine) once daily at night after dinner.
Cutisoft cream (Hydrocortisone) to be applied in small quantities daily at night for ten days.
Withhold pectins for ten days.

Consult a specialist doctor, talk to him or her, and start the medicines with their consent and follow up after ten days.

I hope this helps.

Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

Avoid using Mometasone as it is a potent steroid. Continue applying Cutisoft cream (hydrocortisone) for an additional 10 days only. Afterward, switch to using moisturizer exclusively. Do not use mometasone.

Looking forward to your response in order to help you.

Thank you.

Do chronic itching and burning of the scrotum that does not subside with antifungals suggest scrotal dermatitis?

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