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What kind of a pigmentation do I have?

Q: I have a severe longstanding itch all over the body and the presence of white patches all over the skin. I have finally seen a dermatologist who does not believe I have vitiligo. My partner and I have a very resistant form of scabies which has taken nearly 2 years to eradicate and the itch has been unbelievable. The dermatologist says we have both got a fungal infection on sole of foot and that I have bacterial infection in the armpits and groin. These are the two areas where I have had brown and white patches, a lot of brown colour had appeared. However, he prescribed an anti fungal cream for foot and an antibacterial cotozone cream for the underarms and groin areas. He did a thorough examination of me and would have seen I had these patches of colour all over the body including abdomen, torso and arms etc and a little on toes and fingers. However the instructions were only for the sole of foot and underarms and groin. Can you advise? He sent a scraping from my partners foot to the lab. He said we had extremely sensitised skin at this stage and we still suffer intensely from itch but he believes that the scabies are gone and to take antihistamines long term for the itch. We have to revisit him and he said we should see some improvement in the treated areas by then though not a 100% perhaps he said. I am beginning to see a slight improvement in the armpit area and complete improvement in the foot. However, I do not wish to remain with patches on the other areas of my body. Is this hypo or hyper pigmentation? I no longer know and can it be cured? Why did he not suggest using the cream on other areas affected also? Any advice would be appreciated?

A:It is difficult to speculate about your problem. Probably, you had candidiasis in the body folds for which you were prescribed antifungal creams. It is possible that you had other patches which may not be related to original problem. Some patches do come with ageing. Most of the pigmentation after any inflammation disappears if original cause is treated. Oral contraceptives predispose to candidiasis besides obesity, diabetes mellitus, immunosuppressive therapy, antibiotic therapy etc. Ask your doctor to look into these factors too. Antifungals are also prescribed for tinea (ring worm) in body folds and tinea pedis (foot tinea).

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