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I noticed some patches of white/pigmented skin on both sides

Customer Question
Hi I noticed some patches...
Hi I noticed some patches of white/pigmented skin on both sides and the underside of my scrotum around 18 months to 2 years ago. These became bigger and I then went to see my GP who provided me with anti-fungal shampoo and cream. I wasn't convinced this was the right treatment as I had no lesions - the only difference to the rest of my scrotum was the colour of the skin! However I went with the advice and used the shampoo/creams. This stopped the acceleration but now it is spreading again.
Both sides of my scrotum and the underside of the scrotum (the 'sweatier/warmer' areas) are now completely white/pink and there are also smaller patches on other parts of the scrotum and now two small patches on the shaft of my penis.
I am 32 years old and have no other areas of this pigmentation.
Could this be vitiligo? Or could it be caused by something else? Given the area that this is restricted to is there any way this could be caused by over sweating / over scratching during hotter weather for example?
Thanks
Submitted: 2 years ago.Category: Dermatology
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Answered in 3 hours by:
7/7/2015
Dermatologist: Anthony Bray MD, Physician replied 2 years ago
Anthony Bray MD
Anthony Bray MD, Physician
Category: Dermatology
Satisfied Customers: 10,341
Experience: 14 years of Family Practice Experience including most dermatology problems
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Hello!

From your description it could be vitiligo as a possible cause. It could be tinea versicolor which is caused by a tinea type fungal infection. It sounds that your primary care doctor thought it was this latter cause .

Since you have treated for a fungal infection I would recommend that you consult a dermatologist for follow up evaluation. ( A tinea type fungal infection IS going to be favored by conditions of moisture, warmth and darkness which if course this region favors. Treatmentvif the causing infection would go faster than the later recovery of normal pigmentation. )

Vitiligo is unusually more marked in the change of pigmentation of the skin...

Treatment is different if Vitiligo and this would need to be managed by a dermatologist if that were the cause

I hope that this is helpful for you. Best Regards!

Anthony Bray MD

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Customer reply replied 2 years ago
Thanks. To be honest I first noticed it after a holiday to Portugal a couple of years ago and I have just got back from Spain and have noticed it spreading. I have itched/scratched it over time - could this have the long term effect of pigmentation loss?
Customer reply replied 2 years ago
Also would it be worth sending photos of the effected area? Would these be confidential?
Dermatologist: Anthony Bray MD, Physician replied 2 years ago
Hello again--
It is partially confidential in that only the business aspect of justanswer.com has any access to your account information such as your real name ...you are anonymous to me and anyone whom may read these threads...
The threads are open as to other experts or you being able to access and read other threads..these are connected from our standpoint only your user ID that you picked..
Yes if you feel ok with posting a picture to the page that may be helpful..
The recurrent itching may be a clue ...
The tinea versicolor possibility is usually LESS INTENSE than is vitiligo
Tinea may itch and have very fine scale ( skin looks a bit different ...a bit shiny in oblique light...)
So I hope that this is helpful ..
You are welcome to post pictures if you wish ( YOUR identity is protected but others may gain access to conversation thread including pics as possible )
Selsun lotion is good option if you have tinea versicolor ...
Let me know if you have further questions.I will be happy to get back with you. Best Regards!
Anthony Bray MD
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Customer reply replied 2 years ago
Pics attached - the only symptoms have been itching (not regular but more than usual) and the loss of colour to the itchy areas.This has gone untreated for the last 2 years approx.I have no family history of Vitiligo and no other areas are affected at present.Also I'm 32 years old so quite late to develop something like vitiligo?I'm hopeful it's an infection as opposed to a condition like vitiligo.Is there any way the pigmented skin will recover?
Dermatologist: Anthony Bray MD, Physician replied 2 years ago

Hello again--

It looks more consistent with tinea vesicolor to me. Treatment with application of Selsun lotion or Lamisil cream twice a day for two weeks would usually clear fungus. Pigmentation can recover over time but that is a gradual process ...

You may if you wish consult a dermatologist ...

UV light treatments could be considered to stimulate repigmentation of affected areas of skin( care of course needed to sensitive areas )

Also if tinea then if stubborn or recurrent combination of oral prescription plus topical treatment may be considered)

I hope that this is helpful.Let me know if you have further questions!

Best Regards!

Anthony Bray MD

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Customer reply replied 2 years ago
Thanks so much. I hope you are right. My only concern was that the pigmentation area was smooth (ie no real scaly or dry areas or lesions) which gave me vitiligo panic.I've got an appointment with my GP tomorrow and will hopefully be referred to a dermatologist thereafter.Thanks again
Dermatologist: Anthony Bray MD, Physician replied 2 years ago

You are very welcome.The scale of tinea versicolo is much more fine and not as you typically picture as " scaly" I am glad you are to be seen soon. I agree that is best way to go...

Let me know if I may be of further help...updates welcome

Best Regards,

Anthony Bray MD

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Anthony Bray MD
Anthony Bray MD
Anthony Bray MD, Physician
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