Tinea Cruris: Causes, Signs and Symptoms, Diagnosis, Treatment and Prevention

Tinea Cruris

Tinea cruris or jock itch or ring worm of groin is an itchy superficial fungal infection of the skin of groin and adjacent parts of the body. It is an opportunistic fungal infection (dermatophyte fungal infection), affecting both male and female. Opportunistic fungal infection refers to the illness caused by fungus when the immune system of the patient is depressed. Jock itch is more often seen in males. It is also called tinea inguinalis, where inguin means ‘groin’.

Signs and Symptoms

Signs and symptoms of tinea cruris include erythematous itchy rash (pruritus) or burning sensation in the groin and adjacent areas of the body like thighs and perineum. The lesions of tinea cruris are seen as large erythematous patches of skin with peeling (scales) and cracking.

Causes

Tinea cruris is an opportunistic fungal infection, most often with trichophyton rubrum followed by trichophyton tonsurans and trichophyton mentagrophytes.

Risk factors

Tinea crusis may spread from fungal infection of other body parts like foot (athlete’s foot). Other risk factors include tight clothing as it offers ideal environment (heat and moist) for the growth of fungus. It may also come from the other affected persons during swimming and cloth handling and sharing.

Diagnosis

Most often, tinea cruris is diagnosed clinically as it presents with pruritic erythematous patches (maybe with raised border) on the groin region. Microscopic examination of wet scales from the affected area is diagnostic.  

Differential diagnosis

Differential diagnosis (DD) of tinea cruris includes cutaneous candidiasis, contact dermatitis, acanthosis nigricans, psoriasis and seborrheic dermatitis.

Treatment

Treatment of tinea cruris comprises of topical anti-fungal agents, applied to the affected skin areas. Azole (e.g. ketoconazole, miconazole, etc.) and allylamine (e.g. terbinafine, butenafine, etc.) drug families of antifungal agents are effective and usually used to treat tinea cruris.

• Terbinafine topical cream 1% (Lamisil, Cutis, Terbiderm) is applied to the affected area of the skin once or twice daily for one to two weeks.

• Ketoconazole topical cream 2% (Nizoral, Conaz, Spike, Tezole) twice daily for four weeks is often effective.

• Whitfield's ointment (3% of salicylic acid and 6% of benzoic acid) is an often used antifungal preparation for the treatment of tinea cruris.

• Topical steroid and anti-fungal combination is not recommended, currently.

Prevention

In order to prevent the spread of tinea cruris, keep your groin clean and dry, especially after taking bath, swimming or perspiration (sweating). Do not share your clothing or towel with others. Do not wear tight undergarments and use antifungal powders.

Alternative Names

Many a time, in different areas, different names are used for the same condition. Similarly, tinea cruris is also known as ringworm of groin, jock itch, crotch rot (itch), eczema marginatum, Dhobie itch, gym itch, and more.

Reference

• El-Gohary M, van Zuuren EJ, Fedorowicz Z, Burgess H, Doney L, Stuart B, et al. Topical antifungal treatments for tinea cruris and tinea corporis. Cochrane Database Syst Rev 2014; 8:CD009992. [PubMed]

• Thaker SJ, Mehta DS, Shah HA, Dave JN, Kikani KM. A comparative study to evaluate efficacy, safety and cost-effectiveness between Whitfield's ointment + oral fluconazole versus topical 1% butenafine in tinea infections of skin. Indian J Pharmacol. 2013 Nov-Dec; 45(6): 622-4. [PubMed]

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Keywords: Tinea cruris, Groin itch, Fungus groin, Itchy groin, Jock itch, Dhobie’s itch, Sign and symptoms, Causes, Itch treatment, Tinea cruris treatment, Prevetion, Lamisil cream, Cutis cream