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==Treatment==
==Treatment==
Tinea cruris is best treated with topical [[antifungal medication]]s of the [[Antifungal medication#Allylamines|allylamine]] or [[Antifungal medication#Imidazole, triazole, and thiazole antifungals|azole]] type.<ref>{{ cite journal | author = Nadalo, D.; Montoya, C.; Hunter-Smith, D. | title = What is the best way to treat tinea cruris? | journal = The Journal of Family Practice | year = 2006 | volume = 55 | issue = 3 | pages = 256–258 | pmid = 16510062 }}</ref> These anti-fungal agents stop fungi from producing [[ergosterol]], an essential component of fungal cell membranes. If ergosterol synthesis is completely or partially inhibited, the fungal cell is unable to construct an intact cell membrane, and dies. [[Antifungal medication#Allylamines|Allylamines]] and thiocarbamate antifungals ([[tolnaftate]], ''Tinactin'' etc.) are effective against ''tinea cruris'', but not against ''[[Candida albicans]]'', which requires an [[Antifungal medication#Imidazole, triazole, and thiazole antifungals|azole]] type drug, making azole drugs, effective against both types of infections, the first choice for topical treatment of infections of unknown etiology in [[intertriginous]] areas.
Tinea cruris is best treated with topical [[antifungal medication]]s of the [[Antifungal medication#Allylamines|allylamine]] or [[Antifungal medication#Imidazole, triazole, and thiazole antifungals|azole]] type.<ref>{{ cite journal | author = Nadalo, D.; Montoya, C.; Hunter-Smith, D. | title = What is the best way to treat tinea cruris? | journal = The Journal of Family Practice | year = 2006 | volume = 55 | issue = 3 | pages = 256–258 | pmid = 16510062 }}</ref>


The benefits of the use of [[topical steroids]] in addition to an antifungal is unclear.<ref name=El2012>{{cite journal|last1=El-Gohary|first1=M|last2=van Zuuren|first2=EJ|last3=Fedorowicz|first3=Z|last4=Burgess|first4=H|last5=Doney|first5=L|last6=Stuart|first6=B|last7=Moore|first7=M|last8=Little|first8=P|title=Topical antifungal treatments for tinea cruris and tinea corporis.|journal=The Cochrane database of systematic reviews|date=2014 Aug 4|volume=8|pages=CD009992|pmid=25090020}}</ref> There might be a greater cure rate but no guidelines currently recommend its addition.<ref name=El2012/> The effect of [[Whitfield's ointment]] is also unclear.<ref name=El2012/>
If the skin inflammation causes discomfort and itching, [[glucocorticoid]] [[steroid]]s (such as 1% [[hydrocortisone]] cream) may be combined with the anti-fungal drug to help prevent further irritation due to the patient scratching the area. Apart from the quicker relief of symptoms, this also helps minimize the risk of secondary bacterial infection caused by the scratching. However, steroids may exacerbate the condition if used alone for fungal infections because they hinder the body's immune system.

Since fungi tend to thrive in warm, dark, damp conditions, minimizing these conditions can help treat and prevent this rash. Some useful measures are: wearing boxer underwear or no underwear, increasing air-flow by sleeping near a fan, wearing loose sleepwear or no sleepwear, exposing the area to wind and sun, and thoroughly cleaning the area with a hand-held showerhead and soap.


== See also ==
== See also ==

Revision as of 13:23, 17 September 2014

Tinea cruris
SpecialtyInfectious diseases Edit this on Wikidata

Tinea cruris, also known as crotch itch, crotch rot, Dhobie itch, eczema marginatum,[1] gym itch,[1] jock itch, jock rot, scrot rot and ringworm of the groin[1][2]: 303  is a dermatophyte fungal infection of the groin region in any sex,[3] though more often seen in males. In the German sprachraum this condition is called tinea inguinalis (from Latin inguen = groin) whereas tinea cruris is used for a dermatophytosis of the lower leg (Latin crus).[4]

Tinea cruris is similar to, but different from Candidal intertrigo, which is an infection of the skin by Candida albicans. It is more specifically located between intertriginous folds of adjacent skin, which can be present in the groin or scrotum, and be indistinguishable from fungal infections caused by tinia. However, candidal infections tend to both appear and disappear with treatment more quickly.[2]: 309  It may also affect the scrotum.

Symptoms and signs

As the common name for this condition implies, it causes itching or a burning sensation in the groin area, thigh skin folds, or anus. It may involve the inner thighs and genital areas, as well as extending back to the perineum and perianal areas.

Affected areas may appear red, tan, or brown, with flaking, rippling, peeling, or cracking skin.[5]

The acute infection begins with an area in the groin fold about a half-inch across, usually on both sides. The area may enlarge, and other sores may develop. The rash has sharply defined borders that may blister and ooze.[6]

Causes

Macroconidia from the Epidermophyton floccosum

Opportunistic infections (infections that are caused by a diminished immune system) are frequent. Fungus from an athlete's foot infection can spread to the groin through clothing. Tight, restrictive clothing, such as jockstraps, traps heat and moisture, providing an ideal environment for the fungus.[7]

The type of fungus involved is usually Trichophyton rubrum. Some other contributing fungi are Candida albicans, Trichophyton mentagrophytes and Epidermophyton floccosum.

Prevention

Medical professionals suggest keeping the groin area clean and dry by drying off thoroughly after bathing and putting on dry clothing right away after swimming or perspiring.

Other recommendations are: not sharing clothing or towels with others, showering immediately after athletic activities, wearing loose cotton underwear, avoiding tight-fitting clothes, and using antifungal powders.[8][9]

Treatment

Tinea cruris is best treated with topical antifungal medications of the allylamine or azole type.[10]

The benefits of the use of topical steroids in addition to an antifungal is unclear.[11] There might be a greater cure rate but no guidelines currently recommend its addition.[11] The effect of Whitfield's ointment is also unclear.[11]

See also

References

  1. ^ a b c Rapini, R. P.; Bolognia, J. L.; Jorizzo, J. L. (2007). Dermatology. St. Louis: Mosby. ISBN 1-4160-2999-0.{{cite book}}: CS1 maint: multiple names: authors list (link)
  2. ^ a b James, W. D.; Berger, T. G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. {{cite book}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  3. ^ "Tinea Cruris in Men: Bothersome but Treatable". U.S. Pharmacist. 30 (8): 13–17. 2005.
  4. ^ Altmeyer, P.; Bacharach-Buhles, M. (2002). Enzyklopädie Dermatologie, Allergologie, Umweltmedizin. Springer. p. 1580. ISBN 978-3-540-41361-5.{{cite book}}: CS1 maint: multiple names: authors list (link)
  5. ^ "Jock itch". NYU Langone Medical Center.
  6. ^ "Jock itch". MedlinePlus. NLM / NIH.
  7. ^ "Causes of Jock Itch". Retrieved 2013-01-06.
  8. ^ "Jock itch". Crutchfield Dermatology.
  9. ^ "Jock Itch Causes, Symptoms and Treatment". Everydayhealth. Harvard Health Publications.
  10. ^ Nadalo, D.; Montoya, C.; Hunter-Smith, D. (2006). "What is the best way to treat tinea cruris?". The Journal of Family Practice. 55 (3): 256–258. PMID 16510062.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ a b c El-Gohary, M; van Zuuren, EJ; Fedorowicz, Z; Burgess, H; Doney, L; Stuart, B; Moore, M; Little, P (2014 Aug 4). "Topical antifungal treatments for tinea cruris and tinea corporis". The Cochrane database of systematic reviews. 8: CD009992. PMID 25090020. {{cite journal}}: Check date values in: |date= (help)

External links

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