Tinea cruris: causes, symptoms, diagnosis, and treatment

Tinea cruris is a superficial fungal infection on the inner thighs and perineum, caused by dermatophytes.


Causes

This disease is often caused by epidermophytom floccosum, trichophyton mentagrophytes, and trichophyton rubrum. Sometimes, candida albicans also invades the inguinal area, causing erythematous and desquamative patches, with papules on the edges.


Signs and Symptoms

Tinea cruris usually occurs on the thigh opposite to the scrotum, unilaterally or bilaterally, and skin lesions are mostly annular or semi-annular. A small erythema occurs on the inner side of the upper thighs initially, with scales, gradually extending peripherally into a large, sharply demarcated erythema, with papules, vesicles, and scabs. The central erythema can heal spontaneously, with pigmentation or desquamation. After a protracted duration, local skin infiltration and thickening result in lichenification, and pruritus is often present. In severe cases, the skin lesion often spreads to the perineum and buttocks, and sometimes the scrotum and penis root can be involved.

Figure 1 tinea cruris on the inner thigh

Figure 2 tinea cruris on the buttocks


Diagnosis

On the clinical findings and positive mycological examination, the disease can be diagnosed. If needed, KOH examination can be considered.


Treatment

Topical medications include resorcinol cream, econazole cream, clotrimazole cream, miconazole cream, bifonazole cream, ketoconazole cream, sertaconazole cream, butenafine cream, and terbinafine cream.

Systemic medications are mainly fluconazole, itraconazole, and terbinafine.