Does a fungal infection in the buttocks that have been persistent for 3-4 years sound alarming? medication suggestions would be great.

Butt Rash: Yes, having a fungal infection for one year is alarming. One has to determine if you have a fungal infection or a yeast infection as the oral medications are different for each infection. You may not have a yeast or fungal infection but a contact dermatitis which is a type of allergic reaction to something that comes in contact with your skin. See your dermatologist for a proper diagnosis.