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Tinea cruris (jock itch)

Pathology: * histopathology images [3] Clinical manifestations: 1) erythematous plaque involving inguinal folds 2) papules, vesicles, scales or pustules may stud the border 3) annular/serpiginous scaly patches with central clearing - varying degrees of inflammation in the groin - serpiginous border distinguishes tinea cruris from other causes of annular scaly plaques 4) infection of the groin, pubic region, & thighs - manifests as an annular lesion with a slight scale, an erythematous*, well-demarcated edge, & incomplete central clearing*. 4) scrotum & penis are generally spared 5) concomitant Tinea pedis Tinea cruris are common. * per MKSAP20, light red to pink is erythematous & no discernable central clearing is incomplete central clearing * images [3] Laboratory: - see Tinea - diagnosis is based on microscopic examination - visualization of branching hyphae in the keratin (scale) with potassium hydroxide preparation Differential diagnosis: 1) psoriasis 2) seborrheic dermatitis 3) erythrasma 4) intertrigo does not spare scrotum 5) candidal intertrigo Management: 1) topical imidazole compound for 2-3 weeks a) continue for 1 week after clinical cure b) clotrimazole# (Lotrimin) c) miconazole# (Monistat) d) ketoconazole (Nizoral) e) econazole (Spectazole) f) sulconazole (Exelderm) g) oxiconazole (Oxistat) h) terconazole (Terazol) i) butenafine* (Lotrimin Ultra) [2] 2) topical terbinafine 3) oral antifungals a) griseofulvin (ultramicrosize) 250-375 mg BID for 2-4 weeks b) fluconazole 150 mg/week for 4 weeks c) itraconazole 100 mg/day for 15 days * fungicidal agent # fungistatic agent

General

Tinea

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 997-1000
  2. Prescriber's Letter 9(2):11 2002
  3. Wiederkehr M, Elston DM (images) Medscape: Tinea Cruris http://emedicine.medscape.com/article/1091806-overview
  4. Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025