Tinea cruris is a dermatophyte infection of the groin. Diagnosis is by clinical appearance and by potassium hydroxide wet mount. Treatment is with topical antifungals.
Tinea cruris is a dermatophytosis that is commonly caused by Trichophyton rubrum or T. mentagrophytes.
The primary risk factors are associated with a moist environment (ie, warm weather, wet and restrictive clothing, obesity causing constant apposition of skinfolds). Men are affected more than women because of apposition of the scrotum and thigh.
Typically, a pruritic, ringed lesion extends from the crural fold over the adjacent upper inner thigh. Infection may be bilateral. Lesions may be complicated by maceration, miliaria, secondary bacterial or candidal infection, and reactions to treatment. In addition, scratch dermatitis and lichenification can occur.
Recurrence is common because fungi may repeatedly infect susceptible people or people with onychomycosis or tinea pedis, which can serve as a dermatophyte reservoir. Flare-ups occur more often during summer.
Diagnosis of Tinea Cruris
Clinical evaluation
Potassium hydroxide wet mount
Scrotal involvement is usually absent or slight; by contrast, the scrotum is often inflamed in candidal intertrigo or lichen simplex chronicus.
If the appearance is not diagnostic, a potassium hydroxide wet mount is helpful.
Differential diagnosis of tinea cruris includes
Treatment of Tinea Cruris
Topical antifungal cream, lotion, or gel
(See table Options for Treatment of Superficial Fungal Infections.)
Antifungal choices include terbinafine, clotrimazole, ketoconazole, econazole, ciclopirox, and naftifine.
Itraconazole 200 mg orally once a day or terbinafine 250 mg orally once a day for 3 to 6 weeks may be needed in patients who have refractory, inflammatory, or widespread infection.
Ключові моменти
Suspect tinea cruris when pruritic, ringed lesions extend from the crural fold over the adjacent upper inner thigh, particularly in patients with obesity or in men.
Topical terbinafine, miconazole, clotrimazole, ketoconazole, econazole, or naftifine 2 times a day for 10 to 14 days is usually effective.
