I’ve had psoriasis since my teens, initially mostly on my scalp, but it worsened around age 19 and began affecting my groin and anal areas, along with swaths of my stomach and back. I’ve tried several biologics: Taltz cleared most areas but not my genitals, Ilumya worked best overall but didn’t completely resolve the genital symptoms. While on Ilumya it was relatively controlled as long as I put eucrisa on twice a day, but I was still restricted in a lot of what I did (pre planning showers, not being able to sweat freely, occasional discomfort). I decided to try Bimzelx, but after a few months, I started having discomfort even with eucrisa.
After months of trying different things through my Colorectal and my derm, eventually it got so bad I was in the ER from the pain. I tried a new derm (several, actually) and they pinged the issue as being a fungal infection. I took fluconazole and an anti bacterial, which dramatically improved my symptoms. I then got a biopsy, while temporarily being off Bimzelyx (now restarted after a 3 month break) and it came back as showing…eczema? But the doctors still suspect psoriasis (a second opinion biopsy said dermatitis). I’ve been using zoryve and hydrocortisone once a day, and when I went in, hey! Doctor said I look completely clear.
The problem is, I still have a ton of discomfort. She’s referring me now to a GI, a urologist, and a psoriasis specialist she knows.
My main symptoms are persistent raw, itchy, burning/chafing discomfort around the anus, groin creases, and scrotum. The worst location seems to shift: for a while it was mainly around my anus, but recently the scrotal skin and groin creases have been bothering me most. The scrotum can look somewhat red, particularly on the right side, but the redness comes and goes, and the skin can look relatively normal even when it feels uncomfortable. Heat, sweating, walking, and physical activity tend to aggravate things; cooling down and getting dry can help. I’ve also occasionally experienced sudden prickling/electric-jolt sensations around the groin, thigh creases, and perineal/anal area. My dermatologist recently said the skin looked completely clear and didn’t show steroid-induced thinning, but I’m still experiencing significant discomfort. I’ve wondered about residual skin sensitivity, nerve issues, ongoing dermatitis or fungal infection, or something internal.
Tl; DR. My skin is clear, but I still have symptoms. Biologic said eczema but derm thinks psoriasis. My skin is mostly clear but I still have symptoms. Going to a GI and urologist now, but this stuff is very confusing.