Tinea Cruris

Aka: Tinea Cruris, Jock Itch

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II. Pathophysiology

  1. Often associated with Tinea Pedis
  2. Groin inoculated with patient's hands

III. Etiology (same as Tinea Pedis)

  1. Trichophyton rubrum
  2. Trichophyton mentagrophytes
  3. Epidermophyton floccosum

IV. Epidemiology

  1. More common in teen and young adult males
  2. Also common in teen females who are Overweight or wear occlusive clothing

V. Signs

  1. Distribution
    1. Bilateral thighs
    2. Inguinal folds
    3. Buttocks
  2. Spared areas: Scrotum and penis
    1. Suspect Cutaneous Candidiasis if involved
  3. Characteristics
    1. Asymmetric erythematous annular Plaques
      1. Scaling
      2. Central clearing
    2. Occasional Papules or Vesicles

VI. Differential Diagnosis

  1. Candidiasis (Intertrigo)
  2. Seborrheic Dermatitis
  3. Erythrasma (fluoresces coral red under wood's lamp)
  4. Psoriasis (Inverse)
  5. Lichen Simplex Chronicus
  6. Pemphigus
  7. Contact Dermatitis
  8. Extramammary Paget's Disease

VII. Management

  1. Treat concurrent Tinea Pedis if present
  2. Topical Antifungal cream bid for 2-4 weeks
    1. Technique
      1. Apply to normal skin 2 cm beyond affected area
      2. Continue for 7 days after symptom resolution
    2. First line: Imidazoles (e.g. Clotrimazole)
    3. Refractory cases: Naftin, Lamisil, Loprox, Mentax
  3. Loose fitting clothes, boxer shorts
  4. Powders to reduce moisture
  5. Antibacterial soap

VIII. References

  1. Andrews (2008) Am Fam Physician 77(10): 1415-20 [PubMed]
  2. Schwartz (2004) Lancet 364(9440):1173-82 [PubMed]

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