Questioning My Hidradenitis Suppurativa Diagnosis – Could It Be Something Else? (37M)
I'm a 37-year-old male, standing at 5'11" and weighing 245 lbs. Although I fall into the overweight category, I don’t smoke. My concern centers on the sensitive area at the underside of my thighs where they meet my scrotum (I’ve obscured that part for discretion, but there’s also some mild irritation on the back of it, appearing reddish without any bumps). For the past six weeks, I've been dealing with this skin irritation or rash. I attribute it to an incident where I became overly engrossed in completing a project, accidentally resting a hot laptop on my lap for over three hours without any protective barrier. Due to my tendency to sweat a lot, I didn’t realize how hot and sweaty I was until it became a problem. The discomfort worsens when I sit down or if any fabric comes into contact with the area. I consulted my doctor, who was initially uncertain about the diagnosis and opted to prescribe a steroid cream mixed with an anti-fungal treatment as a precaution. Unfortunately, this remedy was ineffective. Prior to my appointment, I had tried some over-the-counter solutions like hydrocortisone cream and jock itch treatment. Following that visit, my doctor referred me to a dermatologist. Yesterday, I finally had my appointment with the dermatologist. After briefly reviewing some photographs taken by a physician’s assistant and examining my condition for less than a minute, he described it as “pimply” and proposed treating it as hidradenitis suppurativa. He prescribed clindamycin cream for daily use over a month, along with doxycycline 100 mg to be taken twice a day. However, I wonder if my condition could be something different, like erythrasma, given the appearance of patches and the wrinkled texture of my skin. I’ve not experienced any swelling beyond what was observed, and there has been no discharge or pus present. I would appreciate your thoughts on this matter! Thank you for your time and consideration!
Answers (1)
8/14/2025, 7:20:56 PM
OpenHealth AI
It's understandable to feel uncertain about a diagnosis like hidradenitis suppurativa (HS), especially when treatment has not been effective so far. Your concerns about whether it could be something different, such as erythrasma, are valid. Both conditions can cause skin irritation in similar areas, but they have different treatments that can significantly impact your comfort and health.
Understanding Your Condition
- Hidradenitis Suppurativa (HS): This is a chronic skin condition that usually involves painful lumps or abscesses and can occur in areas where skin rubs together, like the thighs or groin.
- Erythrasma: This is a bacterial skin infection that often occurs in moist areas. It typically causes reddish-brown patches and may have a wrinkled appearance, but it tends to be less painful than HS.
Next Steps
Given your symptoms and treatment history, here are some prioritized steps to help you address your concerns:
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Continue Current Treatment: Use the clindamycin cream and doxycycline as prescribed by the dermatologist. Stick to this regimen for at least a month to see if there is improvement, as HS can be resistant to treatment.
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Monitor Symptoms: Keep a diary of your skin condition, noting any changes in symptoms. Pay attention to factors such as skin irritation, changes in color, and any irritation following certain activities (like sitting or sweating).
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Skin Care Practices:
- Hygiene: Gently wash the area with mild soap and water, ensuring it's dry afterwards. Avoid using harsh soaps or scrubbing too hard.
- Moisture Management: Keep the area dry and cool to prevent further irritation. Consider wearing loose, breathable clothing to minimize friction.
- Use of Barrier Creams: If approved by your dermatologist, consider applying a barrier cream or ointment to reduce friction and protect the skin in that area.
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Follow-up Appointment: Schedule a follow-up with your dermatologist in a month to reassess the situation. If your symptoms persist or worsen, express your concerns about the diagnosis and discuss the possibility of erythrasma or other conditions.
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Explore Lifestyle Adjustments: Since you mentioned sweating, consider lifestyle changes that can help manage perspiration—like wearing moisture-wicking clothing and staying in cool environments.
Conclusion
You're on the right path with professional help, and it's crucial to give the current treatment a fair chance while carefully monitoring your condition. If you notice any significant changes or new symptoms arise, don’t hesitate to reach out to your healthcare provider sooner. Your comfort and health are the most important priorities.
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