Diagnosis and management of tinea infections. Am Fam Physician. Topical antifungal treatments for tinea cruris and tinea corporis. Cochrane Database Syst Rev. El-Gohary M, van Zuuren EJ, Fedorowicz Z, et al.Efficacy of oral terbinafine versus itraconazole in treatment of dermatophytic infection of skin - a prospective, randomized comparative study. Indian J Pharmacol. Bhatia A, Kanish B, Badyal DK, Kate P, Choudhary S.Can dermoscopy serve as a diagnostic tool in dermatophytosis? A pilot study. Indian Dermatol Online J. Bhat YJ, Keen A, Hassan I, Latif I, Bashir S.Common tinea infections in children. Am Fam Physician. Residual hyperpigmentation may persist in skin of colour. However, recurrence is common, especially if predisposing factors are not addressed or antifungal treatment is stopped before mycological cure. Tinea cruris clears with appropriate treatment in 80–90% of cases. Mild topical steroid can be used short-term to reduce itch, but is not appropriate as a monotherapy or long-term.Treatment of tinea at other sites such as tinea pedis or tinea unguium.Oral antifungal medication for extensive or recalcitrant infection, particularly in immunosuppressed patients eg, griseofulvin, terbinafine, itraconazole.Topical antifungal medication such as imidazoles or terbinafine.Topical antifungal powder after bathing.Treatment of triggers such as hyperhidrosis or obesity.Careful towelling after washing to avoid transfer of fungi from the feet.What is the treatment for tinea cruris? General and preventative measures Langerhans cell histiocytosis - a rare cause of a flexural rash in a very young child.Flexural dermatose eg, flexural psoriasis, seborrhoeic dermatitis, benign familial pemphigus.Flexural infections eg, candidal intertrigo, erythrasma.What is the differential diagnosis for tinea cruris? Histology demonstrates branching septate hyphae on special stains. Skin biopsy may be performed, usually to exclude other flexural skin conditions. Tinea cruris should be considered in the clinical setting of an asymmetrical scaly rash in the groin and confirmed on a skin scraping for mycology. Tinea incognito due to use of topical steroids.Secondary excoriation, lichenification, and pigmentation.Maceration and secondary infection with bacteria or candida.What are the complications of tinea cruris? Morse code hairs - indicate invasion of vellus hairs.Tinea cruris often causes marked hyperpigmentation in skin of colour. How do clinical features vary in differing types of skin?
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