Tinea cruris
From Wikipedia, the free encyclopedia
Tinea cruris, also known as crotch itch, crotch rot, Dhobie
itch, eczema marginatum,[1]
gym itch,[1]
jock itch, jock rot, and ringworm
of the groin[1][2]:303 is a dermatophyte
fungal infection of the groin region in any sex,[3]
though more often seen in males. In the German
Sprachraum
this condition is called Tinea inguinalis (from Latin inguen = groin) whereas Tinea cruris is
used for a dermatophytosis of the lower leg
(Latin crus).[4]
Tinea Cruris is similar to, but
different from Candidal intertrigo, which is an infection of the skin by Candida albicans. It is more specifically located between intertriginous
folds of adjacent skin, which can be present in the groin or scrotum, and be
indistinguishable from fungal infections caused by Tinia. However,
candidal infections tend to both appear and disappear with treatment more
quickly.[2]:309 It is also worth noting that tinea cruris generally does
not infect the scrotum.[citation needed]
Symptoms
and signs
As the common name for this
condition implies, it causes itching or a burning sensation in the groin area, thigh skin folds,
or anus. It may involve the inner thighs and genital areas, as well as
extending back to the perineum and perianal areas.
The acute infection begins with an
area in the groin fold about a half-inch across, usually on both sides. The
area may enlarge, and other sores may develop in no particular pattern. The
rash appears as raised red plaques (platelike areas) and scaly patches with
sharply defined borders that may blister and ooze.[6]
If the rash advances, it usually
advances down the thigh. The advancing edge is redder and more raised than
areas that have been infected longer. The advancing edge is usually scaly, and
very easily distinguished or well demarcated.
The skin within the border turns a
reddish-brown and loses much of its scale. The border may exhibit tiny pimples or even pustules,
with central areas that are reddish and dry with small scales.[7][8]
If infected with candidal
organisms, the rash tends to be redder and wetter. The skin of the penis may be involved, whereas other
organisms spare the penis.
Causes
Opportunistic infections (infections that are caused by a diminished immune system)
are frequent. Fungus from an athlete's foot
infection can spread to the groin through clothing. Tight, restrictive clothing,
such as jockstraps, traps heat and moisture, providing an ideal environment
for the fungus.[9]
The type of fungus that most
commonly causes tinea cruris is called Trichophyton rubrum. Some other contributing fungi are Candida albicans, Trichophyton mentagrophytes
and Epidermophyton
floccosum.
Prevention
Medical professionals suggest
keeping the groin area clean and dry by drying off thoroughly after bathing and
putting on dry clothing right away after swimming or perspiring.
Other recommendations are: not
sharing clothing or towels with others, showering immediately after athletic
activities, wearing loose cotton underwear, avoiding tight-fitting clothes, and
using antifungal powders.[10][11]
Treatment
Tinea cruris is best treated with
topical antifungal medications of the allylamine or azole type.[12]
These anti-fungal agents stop fungi from producing ergosterol,
an essential component of fungal cell membranes. If ergosterol synthesis is
completely or partially inhibited, the fungal cell is unable to construct an
intact cell membrane, and dies. Allylamines and thiocarbamate antifungals (tolnaftate, Tinactin etc.) are effective
against Tinea cruris, but not against Candida albicans, which requires an azole type drug, making azole drugs, effective against both types
of infections, the first choice for topical treatment of infections of unknown
etiology in intertriginous areas.
If the skin inflammation causes
discomfort and itching, glucocorticoid
steroids
(such as 1% hydrocortisone cream) may be combined with the anti-fungal drug to help
prevent further irritation due to the patient scratching the area. Apart from
the quicker relief of symptoms, this also helps minimize the risk of secondary
bacterial infection caused by the scratching. However, steroids may exacerbate
the condition if used alone for fungal infections because they hinder the
body's immune system.
Since fungi tend to thrive in warm,
dark, damp conditions, minimizing these conditions can help treat and prevent
this rash. Some useful measures are: wearing boxer underwear or no underwear,
increasing air-flow by sleeping near a fan, wearing loose sleepwear or no
sleepwear, exposing the area to wind and sun, and thoroughly cleaning the area
with a hand-held showerhead and soap.
The entire wiki link can be found at: http://en.wikipedia.org/wiki/Tinea_cruris
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