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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4057
Experience:  BSN, MSN, CNS
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Hello - could someone advise me, I have a flat white patch

Customer Question

Hello - could someone advise me, I have a flat white patch on the side of my scrotum = up nearer the thigh area - where it rubs. It is about a 1 inch patch - not circular. It is not painful although sometimes it itches. It is filled with fluid which sometimes seems quite hard. I do sweat a lot down in that area. I did wonder about jock itch syndrome having developed into something else?? The was also a smaller patch on the other side of the scrotum which has cleared up after using bacterial soap and keeping the area dry with talc etc. This larger area persists. The antifungal spray I have, lamasil, dosen't seem to be having any effect - although I am only 5 days into once daily treament. Any idea what this could be - I am reluctant to go to a doctor about this as I am living overseas and don't think I could explain the details exactly, plus it is embarrasing. I first noticed it at Christmas, and have been trying all sorts of things since then - it hasn't changed!
Patrick

folow up - comment

The lamasil has definitely had zero effect. I have also did wondered if it was some kind of seborhic? Cyst, sorry about the spelling. I looked all over the internet but couldn't confirm it as they seem to be lot smaller generally and often multiple numbers.

I think in some way it has to do with friction? Could it have got infected? It doesn't seem like it, as it definitely hasn't got any worse in the last couple of months. The skin patch is totally white.

Another point is that a couple of weeks ago ago after twice daily moist hot flannel compresses I managed to squeeze the clear liquid out. It didn't smell. The skin was red raw underneath and afterwards appeared to be healing fine. Then suddenly it came back overnight! A layer of skin had formed exactly the same as it was before. I had been cleaning the raw area very carefully with soap and water only while it was healing. Certainly no infection got into it.

Patrick



Submitted: 4 years ago.
Category: Health
Expert:  Susan Ivy replied 4 years ago.

DearCustomer

 

Thank you for writing to JustAnswer Health with your question.

 

From your description it does sound likely that this is a fungal infection. The only sure way to know is examination. The most common is types of fungal infection to this area isTinea Cruris which is commonly called 'jock itch".

 

The creams that work well for this, which do include Lamisil, but also, clotMiconazole, and butenofine are creams that are usually applied from 1 week to 4 weeks. Some of the creams to treat this are available over the counter, but stronger creams and oral medications that may work better with resistant infections require precautions or lab's first (to check for liver function, for example) and may also require a prescription. An oral anti-fungal medication such as fluconazole is prescribed in some cases.

 

As it sounds like you are aware of, it is important to keep the area clean with mild soap and water twice daily, drying very thoroughly afterwords (actually, do not use an antibacterial soap, because this can kill the normal bacteria that is present on skin which helps to keep over-growth of fungus from developing). Wearing cotton underwear and loose enough clothing so that air can get to the area to keep it as dry as possible, is also important because moisture is a factor in that helps keep the infection growing and continuing.

 

It is also important to use good hand washing to prevent spread to other areas such as the eye, although this is less likely to happen in a person with good immunity.

 

In 1/2 of men with topical fungal infections such as genital Tinea Cruris it has originated from the feet to the genitals, so it is important to be aware of this if you have any type of infection or itching on your feet as well, to treat the feet as well, and to be careful when putting underwear over feet to prevent recurrence. Also protect your feet if you use a public gym with flip flops or thongs.

 

The anti-fungal creams miconazole or clotrimazole are also effective against yeast infections (Candida albicans) another type of fungal growth, but your infection sounds less likely to be a yeast infection.

 

Since you have already tried two types of creams, it is recommended that you see a physician for the next step, which is collection of a small biopsy of the lesion or affected area for microscopic (laboratory) examination. This will allow for determination of the exact organism so that the exact treatment you need can be started.

 

Any physician commonly treats these infections of the genital region and does not think another thing about examining a person in this area -- you need to look at doctors as being similar to a mechanic, they check individuals "under the hood" every day, so there is really no need for you to be hesitant to be evaluated for any kind of infection that is possible in this area.

 

If you have questions or comments please reply to this post so that I can assist you further.

 

 

 

 

 

 

Customer: replied 4 years ago.
Hello Susan, Thank you very much for your detailed reply - I am very pleased, I am pretty sure you are on the right track. One question though, looking at jock itch photos on the internet it seems as if is a dry scaly type condition? Mine definitely isn't - although it is in the spot where I would expect jock itch to be!!

Finally, do you think Lamisisil cream would have better chance of working? As it has to be appied twice daily whereas the lamisil spray I have been using is wet and only one application a day. Also what about a cream such as canesten as a last try to cure it before going to the Doctor?

Patrick
Expert:  Susan Ivy replied 4 years ago.

The appearance can vary, but it is true that this could be something else or another type of fungal infection. It doesn't sound like any common STD's, but the doctor would be able to check you for that, and again, they do this all the time.

 

Since you have already tried lamisal, I would try one of the other creams that I mentioned above for the specific condition.

 

Clotrimazole is the generic name for Canesten and it is indicated for yeast (Candida albicans infections) alone. For jock itch or athletes foot, more commonly Lotrisone is recommended. It is a combination of clotrimazole and butenofine.

 

I do believe it would be best to try a cream. It does seem like this would more easily adhere to the area, and is the only thing beside an oral medication that I have heard recommended for fungal infections in this area. Give which ever one you try one more week, then you really should see the doctor.

 

 

Susan Ivy, Nurse (RN)
Category: Health
Satisfied Customers: 4057
Experience: BSN, MSN, CNS
Susan Ivy and 6 other Health Specialists are ready to help you
Customer: replied 4 years ago.
Once again excellent, very many thanks - I'll accept your answer.

Patrick
Expert:  Susan Ivy replied 4 years ago.
You are very welcome, Patrick, and I hope this clears up quickly for you.

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