Suggest Treatment For Painful Reddish Rashes On Buttocks And Thighs

Posted on Fri, 20 Feb 2015

Question: I have been taking Kombiglyze for about 3 weeks. I have never had a herpes outbreak anywhere except on the lip about once per year, usually brought on by stress or ill-health. About 3 days ago I started having an irritation (upon inspection I saw what appeared to be a large whitehead pimple) and then a painful reddish rash developed (definitely many tiny "blisters") at the area that joins my thighs to my buttocks. It stops at the base of my scrotum but the area is about 2 inches on each side and extends from the base of the scrotum toward my backside (to the left and right of perineum). 48 hours after it started, last night, there was a good deal of discharge which had a slight "sweaty" odor. I have been with my wife for 13 years and she does have an occasional outbreak but as I said it has never happened to me before. Any opinions are greatly appreciated.

Answered by Dr. Sheetal Verma (3 hours later)

Brief Answer:
Probably Herpes simplex type 2 or Herpes Zoster

Detailed Answer:
Thanks for your query at HCM!
I am Infectious Disease Specialist Dr. Sheetal Verma answering to your query!
I went through your query and understand your concern.

Is there any itching? The lesions appear to be Herpes simplex type 2 which causes genitourinary infection in males. You have to start acyclovir 800mg five times a day orally or 2g intramuscular injection for four times a day will be the best treatment of choice for 5 days. You can also apply 5%ointment of acyclovir for 10 days. Take gabapentin at night for severe pain.
You must also get a discharge collected on swab and send for Tzanck smear to look for viral aetiology and aerobic and anaerobic culture and sensitivity to rule out any secondary bacterial infection as could be carbuncle also. You must also get culture and smear done to look for fungal infection like candidiasis or Tinea versicolor as sometimes it also has similar presentation. As your wife already had such infection so you have a high risk of getting the infection. Also get your wife evaluated.

Happy to take more queries! If you would like some more information I will be happy to provide. You can take a follow-up query. It would be kind if you hit a thanks if found helpful. You can also write a review for me.
Take care! Wish you best of Health.
Dr. Sheetal Verma
Infectious Disease Specialist

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Prasad