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I have slightly darker brown/pink discolored, blotchy area…

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I have slightly darker brown/pink...
I have slightly darker brown/pink discolored, blotchy area on my upper thigh. It does not itch, and has been present for a long period of time. It is about the size of my hand on both thighs, and is slightly present on my crouch, or pubic area. I am male age 18. I am a virgin so I've ruled out the possibility of any kind of STD.
Submitted: 2 years ago.Category: Dermatology
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Answered in 8 minutes by:
6/25/2015
Dermatologist: Dr. Nair, Dermatologist replied 2 years ago
Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9,191
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
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Hello,

Thank you for your question. My name is***** and I will do my best to provide a useful input.

Would a photograph of the affected area be possible at your convenience?

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Customer reply replied 2 years ago
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Dermatologist: Dr. Nair, Dermatologist replied 2 years ago

Thank you for the photograph. Okay so there are two main possibilities for this pigmentation/patch:

1. Erythrasma - This is a bactrial infection caused by a class of bacteria called diptheroids and occurs in the skin flexures (e.g arm pits, groins). If you can see a dermatologist in person the condition can be diagnosed using a wood’s light for examination further confirmed with a skin scraping. Treatment consists of prescription drugs like clindamycin gel/lotion or fusidic acid cream with or without oral antibiotics like doxycycline. If the workup for Erythrasma is negative then other possibilities like Thin Plaque Psoriasis, Seborrheic Dermatitis, and Parapsoriasis need to be considered and these would require a skin biopsy from the rash. None of these conditions are dangerous but treatment will be dictated by the final diagnosis.

2. Pityriasis Versicolor - This is a special type of asymptomatic yeast infection. The condition typically starts in the summers or in hot climates but can persist indefinitely after that unless treated. The color of the patches can range from skin colored to brown to white to red. The condition can be easily differentiated from Erythrasma by a skin scraping for 20% KOH examination.

Treatment consists of:

1. Tab Fluconazole 400 mg one tablet taken as a single dose. Not to be repeated.

2. Oxiconazole cream twice a day over the lesions for 28 days.

3. 2% Ketoconazole (Nizoral-AD) shampoo lathered over the affected area and left on for 2-5 minutes every alternate day for 14 days then twice a week for 14 days then once a week for 2-3 months to prevent a recurrence. Once the yeast has been eradicated (usually 100% after treatment for 14-28 days) normal skin color will return.

No. 1 & 2 are prescription drugs.

If you cannot see a doctor right now for the skin smear/scraping then I'd recommend trying to treat for Pityriasis Versicolor first since it is easier to treat. To this end substitute the Oxiconazole cream with 1% Lotrimin cream which is available over the counter and apply twice a day for 4 weeks. Nizoral-AD shampoo is available over the counter as well and should be started as directed above. Even this regimen should work well.

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.

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