Internal Medicine

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22

1432 Tinea Cruris/Corporis/Pedis

Signs & Symptoms

■Pruritic rash on feet, groin or body skin – exposed areas most affected,

annular patches

■Feet – plantar surface, dry scale, macerated, fissured toe webs

■Onychomycosis

tests

■KOH – septate hyphae

■Fungal culture – growth of dermatophyte

■No blood work indicated

differential diagnosis

■Tinea pedis

➣Eczema, dyshidrosis

➣Psoriasis

➣Bacterial infection (toe web)

■Tinea cruris

➣Cutaneous candidiasis

➣Erythrasma

➣Inverse psoriasis

■Tinea corporis

➣Nummular eczema

➣Pityriasis rosea

➣Psoriasis (guttate type)

➣Granuloma annulare

➣Discoid lupus

management

What to Do First

■Confirm diagnosis by KOH/fungal culture

General Measures

■Topical antifungal agent applied to affected site for 6 weeks depend-

ing on location of infection and product used

specific therapy

■Topical antimycotics – clotrimazole, econazole, ketoconazole, and

ciclopirox olamine

■4–6 weeks – tinea pedis

■2–4 weeks – tinea corporis/cruris