What treatment will help for discolored skin and red circles in inner thigh?

Question

Hello doctor,

I am a 49-year-old fairly healthy male. My height is 6 feet and weight is 260 Ibs. I am overweight and also have low testosterone. I have had a noticeable shrinkage in my testicles in recent years. I have embarrassing erectile issues, including premature ejaculation and often I am unable to maintain an erection. I am not on any regular medication. I do not drink alcohol or smoke. I have attached my photos for your reference. My skin is discolored with red circles on my inner side of the legs up to each side of the scrotum. It frequently itches especially after much walking. The red circles are also present just above my penis, but are obscured by my pubic hair. I am also concerned about a patch of darker skin on my scrotum. There is also a pimple or a tag of skin on my inner right leg; two smaller ones on the inner left leg and one at the top of my right leg where my pubic hair stops. They all sometimes hurt, especially when my innerwear rubs against them. I have had these for years. I was in the hope that they would go away on their own, but now I have noticed a few small ones begins to develop in the same area. There is also a mole or pimple like growth between the base of my scrotum and anus. This hurts or itches when I sit or walk too long. I have not sought treatment to care of these issues before because of embarrassment. What treatment or medication might help? What do you suggest?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I want to reassure you that there is no need to feel ashamed or anxious about your situation; it is a medical issue that can be addressed with proper treatment and guidance. It is great to hear that you don't smoke, as that can worsen your condition.

Based on your height and weight, your BMI is 35, indicating you fall into the borderline to moderately severe obesity category. I recommend consulting an endocrinologist regarding the shrinking of your testicles and erectile issues, as these may be linked to hormonal imbalances or obesity.

The red circles on your inner thighs appear to be a fungal infection known as tinea cruris, which can be treated with antifungal medication. Please consult your specialist to discuss these concerns and obtain the appropriate treatment with their consent.

Tablet Terbinafine 250 mg to be taken once daily for three weeks.
Sertaconazole (antifungal) cream 2 % applied locally twice on the inner thighs and the base of the scrotum.
Tablet Loratadine 9antihistamine) 10 mg to be taken once or twice daily depending on the severity of the itching.
Along with this, apply Calamine lotion once or twice a day to prevent friction between skin folds and also wear pure cotton underclothes to avoid sweating and irritation.

The outgrowths of skin are skin tags and they are usually related to hyperlipidemia. They are not harmful and only have cosmetic concerns. They are best dealt with by simple office-based surgery with a cautery machine requiring only local anesthesia, which is a 5-minute superficial procedure. But, they will not go on their own. You may get your fasting serum lipid profile done, which will measure the levels of cholesterol, LDL (low-density lipoprotein), VLDL (very low-density lipoprotein), and HDL (high-density lipoprotein). If any of these are abnormally suitable, then medicine can be started. Medicine is important as an abnormal lipid profile increases one's risk of cardiac events in the future. One important thing which I cannot emphasize enough would be decreasing your weight. If you can gradually decrease your weight even by a few pounds, you would see a lot of these medical problems would get better by themselves. You may follow up after two to three weeks.

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Every day I examine nearly 10 patients with tinea cruris, so you can see how common it is in tropical countries and hot climates. There is nothing to be so ashamed of as it is a fairly common problem. Other antifungals, which may be used in place of Terbinafine are Fluconazole, Ketoconazole, and Itraconazole. Antifungal creams which may be used in place of Sertaconazole are Clotrimazole, Miconazole, Econazole, Terbinafine and Ketoconazole. Consult your specialist doctor, discuss with him or her and check any one of these available in your location and get the advice about dosage.

Yes, Calamine would help in managing the frictional component of the itch and the Loratadine is given for itching. It is a fairly safe drug. I would congratulate you for shedding those many pounds and would encourage you to keep cutting unhealthy calories, such as sweet and fats from your diet. Do some form of exercise or brisk walk for an average of 20 minutes daily. You can tell your doctor beforehand about shrinkage and erectile issues and then it would not be embarrassing for you to get examined. She could ask you general questions about the duration and evolution of these changes.

I hope this helps.

Thank you.