Tinea cruris

Background

• Dermatophyte infection involving the crural fold
• Colloquially known as 'jock itch'
• Most commonly caused by Tinea rubrum
• More common in men than women
• May result from the spread of other concurrent tinea infections
• More common in obese, diabetics, and immunodeficient

Tinea Types

• Tinea capitis (head)
• Tinea corporis (body)
• Tinea pedis (foot)
• Tinea cruris (groin)

Clinical Features

Tinea cruris

• Begins with an erythematous patch on the proximal medial thigh
• Inward spread with partial central clearing
• Sharply demarcated border, erythematous, elevated
• May spread to perineum, perianally, onto buttocks, or into gluteal cleft
• Typically spares the scrotum

Differential Diagnosis

• Erythrasma (Coral red fluorescence with Wood's lamp)
• Seborrheic dermatitis
• Candidal intertrigo (Erythematous patches with satellite lesions)
• Inverse psoriasis

Testicular Diagnoses

• Testicular torsion
• Epididymitis
• Orchitis
• Torsion of testicular appendage
• Scrotal abscess
• Fournier gangrene
• Hydrocele
• Indirect inguinal hernia
• Hematocele
• Spermatocele
• Testicular trauma
• Testicular rupture
• Varicocele
• Inguinal lymph node (Lymphadenitis)
• Testicular tumor
• Cellulitis
• Tinea cruris

Vulvovaginitis

• Bacterial vaginosis
• Candida vaginitis
• Trichomonas vaginalis
• Contact vulvovaginitis
• Atrophic vaginitis
• Lichen sclerosus
• Tinea cruris
• Chlamydia/Gonorrhea infection

Evaluation

• Typically a clinical diagnosis
• Scraped skin from affected area in KOH prep will show segmented hyphae

Management

• Topical antifungals: Clotrimazole, terbinafine
• treatment to reduce symptoms, prevent secondary bacterial infection, and limit spread
• Systemic antifungals reserved for patients who fail topical therapy
• Systemic antifungals that can be used include: terbinafine, itraconazole, and fluconazole

Disposition

• Outpatient

See Also

• Tinea

References

UpToDate, Tinitnalli's

Authors

Kristina Shigyo, Ross Donaldson, Neil Young