2.1 History and examination:-
A 47- year-old male presented to the dermatology outpatient department with a 3 year history of pruritic skin lesions affecting bilateral groin areas, scrotum and axilla. The lesion was first noticed by the patient as a black scab accompanied by intense pruritus. The lesions followed a relapsing-remitting course over the period of 3 years, and were found to be aggravated by sweating. No history of similar lesions in the family was noted. Patient was initially misdiagnosed to have an allergic reaction and Levocetrizine was started, which did not resolve his symptoms. Subsequently, he sought advice from another medical center where he was diagnosed to have Tinea with secondary infection and was started on medication. After initiation of medication, slight remission was observed, however he relapsed again after a period of 3 months. Subsequently, a KOH mounted microscopy was done, which revealed no hyphae or spores under the light microscope.
Physical examination revealed excoriated bright red papules on bilateral groin areas, scrotum and perineum (Figure 1), as well as few excoriations around the axilla. There was no scalp, palm, soles or nail involvement. There is no evidence of systemic or mucosal involvement.