Dermatology Book

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Tinea CrurisAka: Jock Itch

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  1. Pathophysiology
    1. Often associated with Tinea Pedis
    2. Groin inoculated with patient's hands
  2. Signs
    1. Involved areas
      1. Bilateral thighs
      2. Inguinal folds
      3. Buttocks
    2. Spared areas: Scrotum and penis
      1. Suspect Cutaneous Candidiasis if involved
    3. Characteristics
      1. Asymmetric erythematous annular Plaques
        1. Scaling
        2. Central clearing
      2. Occasional Papules or Vesicles
  3. Differential Diagnosis
    1. Candidiasis (Intertrigo)
    2. Seborrheic Dermatitis
    3. Erythrasma
    4. Psoriasis (Inverse)
    5. Lichen Simplex Chronicus
    6. Pemphigus
    7. Contact Dermatitis
    8. Extramammary Paget's Disease
  4. Management
    1. Treat concurrent Tinea Pedis if present
    2. Topical Antifungal cream bid for 2-4 weeks
      1. Technique
        1. Apply to normal skin 2 cm beyond affected area
        2. Continue for 7 days after symptom resolution
      2. First line: Imidazoles (e.g. Clotrimazole)
      3. Refractory cases: Allylamines (e.g. Naftin, Lamisil)
    3. Loose fitting clothes, boxer shorts
    4. Powders to reduce moisture
    5. Antibacterial soap

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