Thank you for the information. Your history and clinical picture are most suggestive of Nodular Scabies of the genital area. Neurodermatitis
would be a second possibility but is less likely.
Scabies is a skin infestation with a mite (a tiny insect) and is characterized by generalized or scattered itching that is typically worse at night.
The genital area is a typical site for Scabies and in long standing cases produces bumps like you have. This is called Nodular Scabies. Since its impossible to say if the infestation is a persisting just in the genital area or other parts of the body are affected as well (there may be no itching there) it is usually required to treat the full body for Scabies.
Here is what is required as treatment:
5% Permethrin cream to be applied all over the body barring the face and scalp once now and once 7 days after the first application. The cream must be left on the body for 12 hours and then washed off.
Tab Claritin 10 mg twice a day or Benadryl
25 mg three times a day for 14-28 days.
Tab Ivermectin (Stromectol) 12 mg (if body wt>60 kgs), 9 mg (if body wt<60 kgs) - taken once now and once 7 days later (take on empty stomach).
Wash all the clothes and linen in boiling water or the hot cycle of the washing machine.
A combination steroid-antibiotic cream like Fucibet cream or Clobetasol-Gentamycin or Halobetasol-Mupirocin/Fusidic acid applied twice a day on the scrotal bumps for 2-4 weeks. If these don’t flatten out the bumps then steroid injections are the next course of action.
All the people living with you must also be treated with permethrin as advised above even if they are asymptomatic, as usually everyone is affected but only one or two people develop itching. This is very important. Not doing this is the most common cause of treatment failure in scabies.
Lastly please note that the itching of scabies can take 4 weeks to completely disappear even after successful treatment.
I would suggest seeing your doctor with my suggestions since Permethrin, Ivermectol and the steroid-antibiotic creams require a prescription. Till you can mix the Cortizone-10 ointment with Bacitracin ointment (available over the counter) and apply twice a day on the bumps and take the Claritin like I have mentioned (again available over the counter).
Please feel free to ask if you have any queries. I will be happy to continue further and do everything I can to provide you with the service you seek.