By Gary M. White, MD
A red, scaly rash in the groin.
Tinea cruris represents a fungal infection of the groin, usually by a dermatophyte.
- Look for the characteristic annular, red, scaly border.
- Be careful not to confuse tinea cruris with intertrigo.
- Tinea cruris is more common in men as the scrotal skin, pressed against the thigh, provides for a warm, moist environment in which the fungus may grow.
- Both dermatophyte and Candida may be causative.
- For more (explicit) pictures, see gallery.
Red, scaly annular lesions in the groin are typical. The condition commonly extends to the buttocks. If a dermatophyte is causative, a red, scaly rash with a raised, "active", border is typical. With Candida, intense erythema with satellite pustules is seen. The patient complains primarily of itch. KOH examination is positive.
- Topical antifungal medication, e.g. terbinafine or clotrimazole BID x 14 days.
- Oral antifungal medication, e.g. terbinafine 250 mg po x 14 days.
- Keep cool and dry.
- Treat the feet if involved to prevent recurrences.
A topical antifungal agent (e.g. clotrimazole, miconazole) BID should be given acutely. This condition is usually recurrent as long as the groin stays warm and moist. In order to prevent this, the patient should be encouraged to apply a superabsorbant powder, e.g. Zeasorb AF after the shower. A blow dryer (as used for the hair) may be used after the shower to dry the area prior to applying the powder.
Often, patients with tinea cruris have onychomycosis and/or tinea pedis. If present, these should be treated as well as the fungus easily spreads from the feet to the groin. See onychomycosis.
Tinea in the diaper area of an infant.
Fungal hyphae on KOH preparation
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