What causes itchy whitish-gray patches on groin area?

Question

Hello doctor,

I am a 21-year-old male. There are whitish-gray colored patches on the groin area which are roughly round and approximately 0.7 inches in diameter and itches a lot especially during night time. Kindly tell me what the condition is.

Answer 1

Hello,

Welcome to icliniq.com.

I went through your photo (attachment removed to protect patient identity). You have white patches as well as redness. Now redness and itching are due to fungal infection, but white patches are different. White patches are either due to leucoderma or vitiligo. I need to ask you a few questions to make a definitive diagnosis for white patches. Since when do you have these white patches? Does it started after applying some cream? One year back you had a similar complaint, did you have white patches or redness and itching? Is this white patch increasing in size? Did it resolve spontaneously previously? Please revert with answers so I can suggest you diagnosis and treatment for white patches. Treatment for fungal infection i.e. candidiasis are tablet Fluconazole 150 mg one tablet today after dinner and one tablet after 10 days, Clotrimazole cream (Candid gold) cream apply once daily at night for three weeks, and tablet Allegra 180 mg one tablet daily at night for 10 days. Do not apply Benzoyl peroxide lotion.

Answer 2

Hello,

Welcome back to icliniq.com.

So without any history of application of any cream, these patches do look like vitiligo patches. You need to apply Tacrolimus and steroid cream on these white patches. But let this infection subside first as steroid should not be applied on fungal infection. Apply Tacrolimus 0.1% cream once daily in small quantity on white patches at night for three weeks, Fluticasone cream once daily on white patches in small quantity at the afternoon for two weeks. Kindly follow up in three weeks so fungal infection can be assessed, and further approach can be suggested accordingly.