Tinea cruris (jock itch)

Pathology

* histopathology images

Clinical manifestations

• erythematous plaque involving inguinal folds
• papules, vesicles, scales or pustules may stud the border
• 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
• infection of the groin, pubic region, & thighs
  • manifests as an annular lesion with a slight scale, an erythematous*, well-demarcated edge, & incomplete central clearing*.
• scrotum & penis are generally spared
• concomitant Tinea pedis Tinea cruris are common.

* per MKSAP20, light red to pink is erythematous & no discernable central clearing is incomplete central clearing

* images

Laboratory

• see Tinea
• diagnosis is based on microscopic examination
  • visualization of branching hyphae in the keratin (scale) with potassium hydroxide preparation

Differential diagnosis

• psoriasis
• seborrheic dermatitis
• erythrasma
• intertrigo does not spare scrotum
• candidal intertrigo

Management

• topical imidazole compound for 2-3 weeks
  • continue for 1 week after clinical cure
  • clotrimazole# (Lotrimin)
  • miconazole# (Monistat)
  • ketoconazole (Nizoral)
  • econazole (Spectazole)
  • sulconazole (Exelderm)
  • oxiconazole (Oxistat)
  • terconazole (Terazol)
  • butenafine* (Lotrimin Ultra)
• topical terbinafine
• oral antifungals
  • griseofulvin (ultramicrosize) 250-375 mg BID for 2-4 weeks
  • fluconazole 150 mg/week for 4 weeks
  • itraconazole 100 mg/day for 15 days

* fungicidal agent

# fungistatic agent

More general terms

• Tinea