Tinea cruris

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Tinea cruris
Classification and external resources
Specialty Dermatology
ICD-10 B35.6
ICD-9-CM 110.3
DiseasesDB 29140
MedlinePlus 000876
eMedicine derm/471

Tinea cruris, also known as crotch itch, crotch rot, Dhobi 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.

Tinea cruris is similar to, but different from Candidal intertrigo, which is an infection of the skin by Candida albicans. The latter 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 tinea. However, candidal infections tend to both appear and with treatment disappear more quickly.[2]:309 It may also affect the scrotum.

Signs and symptoms[edit]

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.

Tinea is often painful or itchy, but not in every case. There are visual clues to help identify a fungal infection. These include:

  • Inflammation of the groin, anal area and upper thigh - not including the genitals themselves
  • slightly raised patch
  • sharp borders
  • expanding or spreading, with clearing in the center
  • dry or scaly blisters (occasionally oozing or crusting)
  • abnormally dark or light skin
  • skin redness or inflammation

Fungal infections often spread out in a circle, leaving normal-looking skin in the middle. At the leading edge of the infection the skin is raised, red and scaly.

Affected areas may appear red, tan, or brown, with flaking, rippling, peeling or cracking skin.[4]

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.[5]

Causes[edit]

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.[6]

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

Prevention[edit]

Medical Professionals recommend a preventative based approach of stopping fungus before it occurs. Prevention is preferable over a reactive treatment approach. The preventative based approach involves removing heat and moisture to the groin area.[7]

  • Dry off with a clean towel immediately after showering, swimming or perspiring.
  • Shower after physical activities.
  • Wear linen (flax) underwear as they have high air and moisture permeability.[8]
  • Avoid polyester underwear as they promote fungal and bacterial growth.

Treatment[edit]

Tinea cruris is best treated with topical antifungal medications of the allylamine or azole type.[9] The evidence is best for terbinafine and naftifine but other agents may also work.[10]

The benefits of the use of topical steroids in addition to an antifungal is unclear.[10] There might be a greater cure rate but no guidelines currently recommend its addition.[10] The effect of Whitfield's ointment is also unclear.[10]

References[edit]

  1. ^ a b c Rapini, R. P.; Bolognia, J. L.; Jorizzo, J. L. (2007). Dermatology. St. Louis: Mosby. ISBN 1-4160-2999-0. 
  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. 
  3. ^ "Tinea Cruris in Men: Bothersome but Treatable". U.S. Pharmacist 30 (8): 13–17. 2005. 
  4. ^ "Jock itch". NYU Langone Medical Center. 
  5. ^ "Jock itch". MedlinePlus. NLM / NIH. 
  6. ^ "Causes of Jock Itch". Retrieved 2013-01-06. 
  7. ^ "Tinea Cruris Treatment & Management: Medical Care, Diet". 
  8. ^ Maqoo. "Linen Underwear For Maintaining Hygiene". Maqoo. Retrieved 2016-01-23. 
  9. ^ 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. 
  10. ^ a b c d El-Gohary, M; van Zuuren, EJ; Fedorowicz, Z; Burgess, H; Doney, L; Stuart, B; Moore, M; Little, P (Aug 4, 2014). "Topical antifungal treatments for tinea cruris and tinea corporis.". The Cochrane database of systematic reviews 8: CD009992. doi:10.1002/14651858.CD009992.pub2. PMID 25090020. 

External links[edit]