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Curious dermatologist


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RAM Hospital used to have a dermatologist with always a dermatology Bible on his desk and he would show you the appropriate section. I guess he has moved on. I'm looking for a Doc who is still curious enough to find solutions where CANESTEN und Zalain are not the answer. Any suggestions?

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Likely, the OP has a fungal skin condition as CANESTEN und Zalain are used to treat such fungal infections of the foot or other places.

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Fungal is correct, crotch area. Can't use cortisone. Causes big blood clots under skin of hand and arms. That's why someone with an explorativ mind should look for a solution.

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Posted (edited)

It sounds like you have jock itch.  Which you will need to use an anti fungal medication to get rid of it. I have had it a few times in the states and used Lotrimin cream.  But of course what works for one, might not work for another. 
But from the wording of your post it seems like you are looking for a dermatologist recommendation.  I’m not familiar with RAM hospital.  There is one I see in Bangkok and Chiangmai.  If you are in Bangkok I can recommend a dermatologist I see at Samitivej Sukhumvit Hospital.  

 

Edited by swm59nj
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Posted (edited)
1 hour ago, THAIPHUKET said:

Fungal is correct, crotch area. Can't use cortisone. Causes big blood clots under skin of hand and arms. That's why someone with an explorativ mind should look for a solution.

This is an incorrect statement  about cortisone - daktacourt anti fungal preparation come with cortisone

Edited by The Hammer2021
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4 minutes ago, Sheryl said:

Cortisone would in any case be contraindicated for a fungal infection. But Canestan and Zalain should work if it is fungal. How long did you use it? Fungal infections take prolonged treatment to clear up. And essential to keep the area dry. 

 

In Chiang Mai, which I assume is where you are, recommended dermatologists are:

 

Assoc. Prof. Chartchai Kwangsuktith  at Bangkok Hospital.   https://www.bangkokhospital-chiangmai.com/en/doctor/assoc-prof-dr-assoc-prof-chartchai-kwangsukstith-m-d/

 

Prof Dr. Siri Chiewchanvit - at Sripat https://sriphat.med.cmu.ac.th/en/doctor/detail/122

and also seems to have his own clinic at: 119 Moonmuang Road Tel: 053 357085

 

 Dr. Vachiraporn Sujaritwanichpong at Ram https://www.chiangmairam.com/searchdoctor1?major_id=130&doctor=43

Rumor has it she also has a private clinic but I don't know where

 

 

 

 

What about Pattaya? Even the big hospitals don't seem to have many treatment options. No UVB Band therapy, don't even do a patch allergy test.

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Posted (edited)

I have found creams and ointments, while they may work, can make things more uncomfortable. I had this powder prescribed for a heat-related underarm rash that worked great. I have subsequently used it on jock itch and it the rash was gone within 48-hours. It was also used on the nipper's nappy rash (when he was a nipper).

 

Mycoderm-C Clotimazole Dusting Powder

 

https://www.lazada.co.th/products/1-mycoderm-c-clotimazole-dusting-powder-1-75-g-i578830522-s1067912710.html

 

https://www.nhs.uk/medicines/clotrimazole/

Edited by NanLaew
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Just now, NanLaew said:

I have found creams and ointments, while they may work, can make things more uncomfortable. I had this powder prescribed for a heat-related underarm rash that worked great. I have subsequently used it on jock itch and it the rash was gone within 48-hours.

 

Mycoderm-C Clotimazole Dusting Powder

 

https://www.lazada.co.th/products/1-mycoderm-c-clotimazole-dusting-powder-1-75-g-i578830522-s1067912710.html

 

https://www.nhs.uk/medicines/clotrimazole/

Clotrimazole is the main ingredient in Canesten which the OP has already indicated doesn't work for him.

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Buy a sheet of Fluconazole 200mm.  10 capusle over the counter at most pharmacies for about 50baht.  Take two each day like a course of antibiotics until sheet finished.

 

You can thank me later.

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17 minutes ago, Sheryl said:

I think he is describing his personal response to cortisone. This is a known side effects from use of cortisone cream  in older people.

 

In addition, cortisone and other steroids are not advisable with a fungal infection as they support fungal growth. It is true that many Thai preparations combine an antifungal with a steroid but unless symptoms are utterly unbearable, best to treat with an antifungal alone.   https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=471

 

 

Thank you for your advice. I have been prescribed  Dactacourt or Dactarin for fungal infections and found them to be more effective  than canastan. I shall bring this matter  up with my doctor

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If you are referring to Chiang Mai Ram Hospital my family and I plus several expats we know, have consulted with Dr Vachiraporn ( first name) for several years.

I have never seen her consult a medical text book and found her services excellent.

For what it’s worth I understand that she has also completed training in Boston USA.

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1 hour ago, sawadee1947 said:

Take ciclopirox creme and liquid.

Takes a while but it's working☺️

That's so true, recently I've got problems in the groin, and the doctor gives me Loprox (ciclopiroxolamine) but in combination with tablets. After 6 weeks it was over, unfortunately I don't remember the name of the tablets.

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1 hour ago, Peterphuket said:

That's so true, recently I've got problems in the groin, and the doctor gives me Loprox (ciclopiroxolamine) but in combination with tablets. After 6 weeks it was over, unfortunately I don't remember the name of the tablets.

Probably fluconacole, itraconacole, nystatine or terbinafine

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14 minutes ago, sawadee1947 said:

Probably fluconacole, itraconacole, nystatine or terbinafine

Thanks, but I have to find out.

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6 hours ago, THAIPHUKET said:

Fungal is correct, crotch area. Can't use cortisone. Causes big blood clots under skin of hand and arms. That's why someone with an explorativ mind should look for a solution.

After shower, I have used Dermcombin when I get crotch itch. The other remedy I have sed is a powder (use powder puff) I got at Bic C at Pantip in Chiang Mai.

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16 hours ago, Sheryl said:

You can get skin testing at almost all the large private hospitals in Bangkok

https://www.bumrungrad.com/en/treatments/allergy-skin-testing

Need to go to allergy clinic though not derm clinic

 

It is also available at BPH. Whom exactly did you talk with that said it was not? The sinus & allergy clinic does skin tests, or at least they used to.

 

Narrow-band UVB is used here for vitiligo and  psoraiasis, for sure they do it at Siriraj

https://www2.si.mahidol.ac.th/en/dermatology/photomedicine-division/

The person who handles appointments. They said blood allergy test only. Looks like I'll be making a trip to Bangkok then, thank you.

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I've seen dermatologists, dentists,  cardiologists and a surgeon  All of them readily refer to the computer on their desk to show me exactly  to what they're referring.

 

A few  years back I was directed to a surgeon at a Bangkok Hospital and after seeing the concentrated mass of pimples in the middle of my back he swung his computer screen around so I could see images of carbuncles.   He said I'd need to have the one on my back excised.    I asked how much and he gave me a low ball figure.   I then asked when he could do it and he said right now.      Forty  minutes or so later I had a 1 1/2 inch X 1/2 " by 3/4 inch deep hole in my back that he stuffed with gauze.

 

Carbuncles aren't pleasant.

 

Never once in all the times I've used a doctor in Thailand  has one referenced a handbook instead of a computer.

 

 

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3 hours ago, In Full Agreement said:

 

 

I've seen dermatologists, dentists,  cardiologists and a surgeon  All of them readily refer to the computer on their desk to show me exactly  to what they're referring.

 

A few  years back I was directed to a surgeon at a Bangkok Hospital and after seeing the concentrated mass of pimples in the middle of my back he swung his computer screen around so I could see images of carbuncles.   He said I'd need to have the one on my back excised.    I asked how much and he gave me a low ball figure.   I then asked when he could do it and he said right now.      Forty  minutes or so later I had a 1 1/2 inch X 1/2 " by 3/4 inch deep hole in my back that he stuffed with gauze.

 

Carbuncles aren't pleasant.

 

Never once in all the times I've used a doctor in Thailand  has one referenced a handbook instead of a computer.

 

 

We live in the computer age so indeed the internet is the storage for medical information just as for everything else although PDR is still published.  In the old days do recall reading PDR (Physicians Desk Reference) for information on treatment when in Dacca/Dhaka during the war of 1971 as other than one expat Brit doctor (who was good) there was not much available.  Had to fly India/Bangkok after war ended to have a tooth extracted.  

image.jpeg.82a0a7f03346fbf6bba4f141c04066ae.jpeg

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22 hours ago, sawadee1947 said:

terbinafine

Having played football for some 40 plus years, as well as tennis for at least 10 years, jock itch/similar has been a not infrequent companion over the years, and I tried many things, all of the ones mentioned, but In recent times, terbinafine cream has worked well for me and seems to act more quickly in clearing up the total fungal infection, which if not cleared up completely, can come back again very quickly.

 

Outside of that, these days I use a "dusting powder" in the groin which contains clotrimazole, as an everyday "prophylactic", if you wish.

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Posted (edited)
22 hours ago, sawadee1947 said:

Probably fluconacole, itraconacole, nystatine or terbinafine

It was terbinafine, today I've got the confirmation.

Thank you.

Btw, '47 was a good year of construction. 😉

Edited by Peterphuket
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Posted (edited)

If you have any fungal issues, consider using this supplement: Thorne Research, Formula SF722.

 

I had ongoing issues with fungal problems - nail fungus, ringworm and various issues associated with Candida overgrowth from gut issues to white tongue. This supplement worked wonders. Google it and read the reviews. You can order it online from iHerb. It's available on Lazada although it's pricier than if ordering from iHerb in the States.

 

Just remember that many fungal issues are not just in one area so while you might treat say ringworm, as I did, with Cannesten cream, it might be that you unknowingly have yeast / fungal issues elsewhere. That's why something like this supplement or an anti-fungal like Fluconazole might be a better solution that a skin cream.

Edited by mstevens
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