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Tinea Cruris

  • Author: Michael Wiederkehr, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Nov 18, 2015
 

Background

Tinea cruris, a pruritic superficial fungal infection of the groin and adjacent skin, is the second most common clinical presentation for dermatophytosis. Tinea cruris is a common and important clinical problem that may, at times, be a diagnostic and therapeutic challenge.

Other Medscape articles on tinea infections include Tinea Barbae, Tinea Capitis, Tinea Corporis, Tinea Faciei, Tinea Nigra, Tinea Pedis, and Tinea Versicolor.

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Pathophysiology

The most common etiologic agents for tinea cruris include Trichophyton rubrum and Epidermophyton floccosum; less commonly Trichophyton mentagrophytes and Trichophyton verrucosum are involved. Tinea cruris is a contagious infection transmitted by fomites, such as contaminated towels or hotel bedroom sheets, or by autoinoculation from a reservoir on the hands or feet (tinea manuum, tinea pedis, tinea unguium). The etiologic agents in tinea cruris produce keratinases, which allow invasion of the cornified cell layer of the epidermis. The host immune response may prevent deeper invasion. Risk factors for initial tinea cruris infection or reinfection include wearing tight-fitting or wet clothing or undergarments.

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Epidemiology

Frequency

United States

Dermatophytosis accounts for approximately 10-20% of all visits to dermatologists.[1]

International

Tinea cruris has a worldwide distribution but is found more commonly in hot humid climates.[2, 3]

Sex

Tinea cruris is 3 times more common in men than in women.

Age

Adults are affected by tinea cruris much more commonly than are children. However, the prevalence of several risk factors for tinea cruris, such as obesity and diabetes mellitus, is rapidly increasing among adolescents.[4]

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Contributor Information and Disclosures
Author

Michael Wiederkehr, MD Consulting Staff, Livingston Dermatology Associates; Consulting Staff, Comprehensive Dermatology and Laser Center

Michael Wiederkehr, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Lester F Libow, MD Dermatopathologist, South Texas Dermatopathology Laboratory

Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Texas Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Gregory J Raugi, MD, PhD Professor, Department of Internal Medicine, Division of Dermatology, University of Washington at Seattle School of Medicine; Chief, Dermatology Section, Primary and Specialty Care Service, Veterans Administration Medical Center of Seattle

Gregory J Raugi, MD, PhD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References
  1. Foster KW, Ghannoum MA, Elewski BE. Epidemiologic surveillance of cutaneous fungal infection in the United States from 1999 to 2002. J Am Acad Dermatol. 2004 May. 50(5):748-52. [Medline].

  2. Sadri MF, Farnaghi F, Danesh-Pazhooh M, Shokoohi A. The frequency of tinea pedis in patients with tinea cruris in Tehran, Iran. Mycoses. 2000. 43(1-2):41-4. [Medline].

  3. Yehia MA, El-Ammawi TS, Al-Mazidi KM, Abu El-Ela MA, Al-Ajmi HS. The Spectrum of Fungal Infections with a Special Reference to Dermatophytoses in the Capital Area of Kuwait During 2000-2005: A Retrospective Analysis. Mycopathologia. 2009 Nov 17. [Medline].

  4. Patel GA, Wiederkehr M, Schwartz RA. Tinea cruris in children. Cutis. 2009 Sep. 84(3):133-7. [Medline].

  5. Silva-Tavares H, Alchorne MM, Fischman O. Tinea cruris epidemiology (São Paulo, Brazil). Mycopathologia. 2001. 149(3):147-9. [Medline].

  6. Koksal F, Er E, Samasti M. Causative agents of superficial mycoses in Istanbul, Turkey: retrospective study. Mycopathologia. 2009 Sep. 168(3):117-23. [Medline].

  7. Torok L, Tiszlavicz L, Somogyi T, Toth G, Tapai M. Perianal ulcer as a leading symptom of paediatric Langerhans' cell histiocytosis. Acta Derm Venereol. 2000 Jan-Feb. 80(1):49-51. [Medline].

  8. Chang CH, Young-Xu Y, Kurth T, Orav JE, Chan AK. The safety of oral antifungal treatments for superficial dermatophytosis and onychomycosis: a meta-analysis. Am J Med. 2007 Sep. 120(9):791-8. [Medline].

  9. Parish LC, Parish JL, Routh HB, Avakian E, Olayinka B, Pappert EJ, et al. A double-blind, randomized, vehicle-controlled study evaluating the efficacy and safety of naftifine 2% cream in tinea cruris. J Drugs Dermatol. 2011 Oct 1. 10(10):1142-7. [Medline].

  10. Choudhary S, Bisati S, Singh A, Koley S. Efficacy and Safety of Terbinafine Hydrochloride 1% Cream vs. Sertaconazole Nitrate 2% Cream in Tinea Corporis and Tinea Cruris: A Comparative Therapeutic Trial. Indian J Dermatol. 2013 Nov. 58(6):457-60. [Medline]. [Full Text].

  11. Plaum S, Verma A, Fleischer AB Jr, Olayinka B, Hardas B. Detection and relevance of naftifine hydrochloride in the stratum corneum up to four weeks following the last application of naftifine cream and gel, 2%. J Drugs Dermatol. 2013 Sep. 12(9):1004-8. [Medline].

  12. Bakos L, Brito AC, Castro LC, et al. Open clinical study of the efficacy and safety of terbinafine cream 1% in children with tinea corporis and tinea cruris. Pediatr Infect Dis J. 1997 Jun. 16(6):545-8. [Medline].

  13. Bonifaz A, Saul A. Comparative study between terbinafine 1% emulsion-gel versus ketoconazole 2% cream in tinea cruris and tinea corporis. Eur J Dermatol. 2000 Mar. 10(2):107-9. [Medline].

  14. Chen S, Ran Y, Dai Y, Lama J, Hu W, Zhang C. Administration of Oral Itraconazole Capsule with Whole Milk Shows Enhanced Efficacy As Supported by Scanning Electron Microscopy in a Child with Tinea Capitis Due to Microsporum canis. Pediatr Dermatol. 2015 Oct 8. [Medline].

 
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Tinea cruris.
Tinea cruris.
Tinea cruris.
Tinea cruris (hematoxylin and eosin stain).
Tinea cruris (periodic acid-Schiff stain, magnification X 20).
Tinea cruris (Gomori methenamine-silver stain, magnification X 20).
 
 
 
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