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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Doctor
Category: Dermatology
Satisfied Customers: 6686
Experience:  MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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I have been itchy scrotum for almost a month and tried

Customer Question

Hello
JA: Hello. What seems to be the problem?
Customer: I have been itchy scrotum for almost a month and tried Lotrimin and Lamisil for almost a month
JA: How long have you been dealing with this? Does anything in particular seem to make the itch better or worse?
Customer: 1.5 months
JA: Anything else in your medical history you think the doctor should know?
Customer: no that is it
Submitted: 2 months ago.
Category: Dermatology
Expert:  Dr. Muneeb Ali replied 2 months ago.

Hi,
Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. can i ask do you also have a rash in the area? Any urinary symptoms? Any swollen lymph nodes in the groin? Have you gotten tested for this?

Customer: replied 2 months ago.
No, the skin is super red but I do not have any urinary symptoms or swollen lymph node. I contacted my physician and she originally thought it is a fungal issue and she prescribed NYSTOP 100,000 which did not help. I complained more this morning and she consulted with a dermatologist and she now thinks it is mild irritant dermatitis/ pruritus scroti. I need a second opinion.
Expert:  Dr. Muneeb Ali replied 2 months ago.

Thanks for the additional information, let me just write down an answer for you and ill get back to you in a few mins. If you get a phone call request, that is an automated site response. I DID NOT send it. Thanks!

Expert:  Dr. Muneeb Ali replied 2 months ago.

Actually from the picture that you have attached it does seem likely that this is scrotal eczema or scrotal dermatitis. Given that the area is very itchy and the skin seems to be inflamed AND the fact that you did not respond to anti fungal medications, makes this diagnosis very likely. In most cases of dermatitis in this region, the skin may thicken over time and may appear leathery. Now the treatment here is mainly to control the itching, these can include,

  • corticosteroid creams like OTC hydrocortisone or stronger prescribed preparations
  • corticosteroid injections for severe eczema that’s not controlled by creams
  • steroid-free anti-inflammatory medications like pimecrolimus (Elidel) cream and tacrolimus (Protopic) ointment to suppress your immune system response
  • anti-anxiety medications
  • absorbent powders, such as pramoxine topical (Gold Bond)
  • ultraviolet B (UVB) radiation therapy

Regarding pruritus scroti, that is a condition in which the itching develops after an infection of some sort, in your case it is possible that you did have a fungal infection which was treated with the anti fungal medications that you were on but that gave rise to the pruritus scroti and now your symptoms are due to this issue, again steroid creams and injections would be effective here.

But in short i do agree with your dermatologist, i would consider dermatitis as the first possibility and go for steroid creams to control the symptoms.

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