
What Causes Circular/patchy Skin Rash On Upper Thigh?

The rash looks like any number of things (ringworm in particular), but how can I determine the cause of it? I could post photos or send them - is that allowed?
What can one do to eliminate possible causes (such as psoriasis, eczema, herpes simplex, jock itch, ringworm, yeast - any others?).
the red patches have been there for about 3 months, and the borders have shifted a little bit, but it has not improved much at all. It is not bothersome, but is slightly itchy if area is brushed or scratched. The red area is raised slightly and has dry skin flaking (no pain, discharge, or signs of infection with bacteria, like a follicular infection).
I am currently treating with OTC anti-fungal miconazole nitrate, but it has not made much of a difference - it says to use it 4 weeks and it has been 2 weeks so far. I have not tried any steroidal treatment as I did not want to make things worse if it was viral or fungal infection.
I plan to see a doctor if it gets worse, but I am in a rural area and hoping to attempt to cure it with OTC remedies if possible.
Tinea cruris; oral and topical antifungals
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic
I am Dr. Kakkar. I have gone through your query and I have understood it. I have also seen the photographs
I will keep a possibility of Fungal Infection of the groin folds (Tinea Cruris). Groin folds are a common site for fungal infection because of the moist, humid conditions that prevail in the folds, specially in hot and humid weather. This provides an ideal environment for the fungus to proliferate.
Tinea cruris classically presents as annular patches with scaly, red, raised margins and central clearing. Itching is bothersome.
You may try for him an OTC topical antifungal e.g clotrimazole 1% cream or you may continue with miconazole cream, twice daily for 4-6 weeks.
Apart from the topicals I would also suggest Oral antifungals e.g fluconazole for faster and more effective response.
Oral antifungals are prescription drugs and therefore I would suggest that you talk to your doctor for the needful
An OTC oral antihistamine e.g cetrizine 10 mg daily would help in providing symptomatic relief from itching.
Regards


Also, is there a chance it could be herpes? It comes and goes in patchy clusters like herpes could and 25% of people in my country have herpes . . . it is very common.
Thank you.
Tinea cruris is the likely diagnosis
Detailed Answer:
Hi.
The distribution of the rash goes more in favor of Tinea cruris. That is my first possibility. Psoriasis or Seborrheic dermatitis are always in the differential diagnosis of round or annular, scaly, red, itchy patches.
Psoriasis typically involves other body sites more commonly like scalp and extensor surfaces e.g elbow, knee, lower back etc. Scaling is candle wax like or silvery white. However, flexures like inner thighs may also be involved in psoriasis(Sebopsoriasis).
Seborrheic dermatitis also involves other body sites like scalp and face more commonly. The patches are faintly erythematous with yellowish greasy overlying scaling.
A physical examination is usually good enough to distinguish Tinea from psoriasis and seborrheic dermatitis. Therefore I suggest you to visit a specialist for a confirmatory diagnosis.
A KOH examination for fungal elements would also confirm whether it is a fungal infection or not.
Herpes is very different from this; fluid filled vesicles are characteristic of herpes. This rash is unlikely to be herpes.
Regards


This rash does'nt look like herpes
Detailed Answer:
Hi.
Herpes can be easily diagnosed clinically. Fluid filled lesions are characteristic of herpes. This rash does'nt look like herpes.
However, if you desire, you may take a blood test for Herpes (HSV ELISA for type 1 & 2 virus).
Regards

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