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Is severe itching on the testicles due to eczema?

Q: I have a severe itching problem on my testicles since last 12 years. The skin is red and also has some hard pimples. While rubbing the area the skin becomes dry. Itching is more active at night, especially when there is sweating in the area. I have used a lot of medicines like Scab lotion, corotex hc, quodiderm, nizrol, allegra etc. Right now I am taking a homeopathic medicine but it is not helping me either. What should I do and whom should I contact? The infection has spread to the entire anal region. I can't sit properly now. Presently I am being treated for eczema.

A:Although nothing beats seeing the patient in person but by the nature of your description of the problem, it seems to be a kind of eczema known as Lichen Simplex Chronicus (LSC). Lichen Simplex Chronicus (LSC) is actually more of a symptom than a specific disease itself. The skin eruption is created by habitually scratching a certain area over a long period of time. This scratching causes characteristic changes such as thickening and darkening of the skin, and an accentuation of normal skin lines. These changes are called lichenification. Lichen Simplex Chronicus is seen in people with eczema. Although eczema can affect the whole body, the eruption of LSC in usually found in one area. The nerve endings in this area are irritable and trigger an itch-scratch-itch cycle. The more the eruption is scratched or rubbed, the more it itches, continuing the cycle. Areas most commonly affected are:

  • Outer lower portion of lower leg
  • Wrists and ankles
  • Back and side of neck
  • Forearm portion of elbow
  • Scrotum, vulva, anal area, pubis
  • Upper eyelids
  • Opening of the ear
  • Fold behind the ear The most important part of treatment is understanding that all itching, rubbing, and even touching of the rash must stop. Since many people scratch in their sleep, the area may have to be covered. Local steroid creams and anti-histamines are the drugs of choice as the other diagnosis which come to my mind i.e. Scabies and Fungal infection. I personally have my doubts whether they can last for 12 years though a capable dermatologist will rule them out in no time. LSC is my best guess from this side of the computer.

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