I reviewed the images and the reports (attachment removed to protect the patient's identity). It appears as tinea cruris. Tinea cruris is a fungal infection most often seen on the folds and private areas where exposure is less. They appear due to the stagnation of sweat and moisture. Private areas, groin, and buttock areas are major skin fold areas that would be affected. The other areas to be affected are the underarms, the abdomen, and the folds of arms and legs. They may also form due to decreased immunity, spread from an infected person, hygiene issues, climate changes, and hormonal changes. Symptoms can include itching, oozing, foul-smelling secretion, and pain or redness occasionally. Itching is the most common feature, which may lead to discomfort throughout the day, especially when sweating. I suggest you follow the following advice and medicines.
Keto (Ketoconazole) soap is to be used for bathing twice daily. Lather the soap with water and apply it on affected areas only. Keep for 3 minutes and then wash off. Do not use this soap on unaffected areas. Use regular soap on other areas of the skin.
Apply Terbinafine (Terbinaforce) cream twice daily. After bathing, clean the areas well, towel dry, air the areas to get rid of moisture, and apply Terbinafine cream. Make sure to wash your fingers well after applying the cream.
Apply Terbinaforce (Terbinafine) dusting powder in the afternoon and evening on the affected area to get rid of itching and absorb moisture. Twice daily application is advised.
Take an antifungal capsule, Itraconazole (Sporanox) 200 mg, once daily at night after food for four weeks.
Take tablet Cetirizine (Zyrtec) 10 mg one hour before sleeping at night for one week. Ensure not to go out or drive after consuming this tablet, as it is a sedative. They help with excess itching.
Avoid stagnation of moisture and sweat. Wipe out in case of sweating and air the area well under a fan from time to time.
Wear loose clothing and underwear. Dry your used belongings under the sun every day after washing them.
If your family members or friends are affected, ensure they get treatment to prevent recurrences.
For maintaining immunity, capsule Becosule Z (Vitamin B1, Vitamin B2, Vitamin B3, Vitamin B6, Vitamin B7, Vitamin B9, Vitamin B12, Vitamin B5, Vitamin C, and Zinc) or any multivitamin tablet containing vitamin B complex, vitamin C, and zinc can be taken once daily after breakfast for one month.
Tinea cruris will take time to reduce and fade off due to the extent of the infection and the location being unexposed areas. It may take from weeks to months to lessen in severity and fade. Therefore being consistent and patient with the medication is important.
Thank you for the reply.
Whatever medications you have prescribed, will they be available in my country since I am studying here?
Yes, I did notice that you reside in a different country. Therefore I have provided all the medications in the form of generic names so that you can buy them easily from a pharmacy using these generic names in their brands. The multivitamins. However, I have mentioned the most important contents in it. Therefore you may avail any brand of multivitamins as all have similar contents.
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