Patient's Query
Hi doctor,
I am 38 years old. I am diabetic for the past three years and sugars are not always in control. I am taking medicine Euclide 80 mg and Galvus met 50/500 and Novomix 30 injection 10 units (injection only for few days). My issue is, post diabetes I am experiencing severe recurring yeast infection in vagina and itching in groin area and near anal area. Due to scratch the area has become sensitive and scars and cuts are there. There is burning sensation when the area comes in contact with water. I have tried all Clotrimazole creams (Dres V, Surfaz B, Candid, etc.), but no relief. Itching is severe at night and very uncomfortable. Please help which medicine or cream to apply to stop this infection everytime. I am unsure if that is eczema. Are there any tests which show what kind of infection is that?
Hi,
Welcome to icliniq.com.
Diabetes is comorbidity that makes patients prone to fungal infections and some times there is a secondary bacterial infection too.
I advise you to follow certain steps.
1. First step, proper sugar control.
2. Anti-diabetic diet and exercise.
3. Proper genital hygiene.
4. Use of clean cotton underwear.
5. Keeping the area clean and as dry and aerated as possible.
6. No tight clothing.
7. No talcum powder application.
8. Do not use regular soap and hot water to clean genital areas.
Take Itraconazole 100 mg two times a day for two weeks, Luliconazole cream to be applied three to four times daily on area of infection after proper cleaning and drying. Combinorm wash to clean the genital area.
I hope this helps.
The Probable causes
Differential diagnosis
Treatment plan
Regarding follow up
Patient's Query
Thank you doctor,
Thanks for your reply. I am really concerned about the bad smell of urine and any specific foods which can help. Please suggest.
Hi,
Welcome back to icliniq.com.
I hope your symptoms have subsided. Combinorm wash will reduce the foul-smelling. Now we are exploring foods that are beneficial for your vaginal flora. You can take cranberry juice, yogurt, sweet potatoes, garlic, soy, avocados, apples, flaxseeds, water, almonds, pumpkin seeds, and hot chilies. I hope this helps.
Patient's Query
Thank you doctor,
Thanks for your reply. The itching is still there at night. Since the lockdown is there, I am not getting Combinorm wash. Can I use any alternative brand? It is still the same. There is discoloration, and it is worse there. Can I send you a picture?
Hi,
Welcome back to icliniq.com.
Sorry for the inconvenience you are facing.
1. For itching, please take a tablet Cetirizine before dinner at night for ten days.
2. Other alternatives to Combinorm wash are V wash and Saugella Attiva.
3. Have you started taking other medicines?
4. Is there any relief?
5. How is your blood sugar control?
6. Yes, please send a picture
7. Avoid itching at any cost, as it will worsen your condition.
I hope this helps. Please follow up with answers.
Patient's Query
Thank you doctor,
I have completed the course of other medications which you provided. There is cracking and splitting of the skin. Hence there is burning when I wash the area. Itching is unbearable and unavoidable at night.
Hi,
Welcome back to icliniq.com.
Tablet Itraconazole has to be taken for two weeks along with the Luliconazole ointment. You have used it only for five to six days now. So please continue with all my previous advice. But let me be very clear, if your diabetic control is not good, the infection may persist for months. So maintain proper hygiene and allow as much ventilation as possible to the area. Any rubbing or friction, or itching will increase the area of involvement.
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