Tinea cruris

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Tinea cruris
Other namesEczema marginatum, crotch itch, crotch rot, dhobi itch, gym itch, jock itch, jock rot, scrot rot [1] [2] :303
Tinea cruris.jpg
Tinea cruris on the groin of a man
Specialty Dermatology
Symptoms Itch, rash in groin
Risk factors
  • Excessive sweating
  • Diabetes
  • Obesity
Diagnostic method Microscopy and culture of skin scrapings
Differential diagnosis
  • Treat any fungal infections of feet or nails.
  • Keep groin region dry
  • Avoid tight clothing
  • Losing weight if obese
  • Always put on socks before underwear
Medication Topical antifungal medications

Tinea cruris, also known as jock itch, is a common type of contagious, superficial fungal infection of the groin and buttocks region, which occurs predominantly but not exclusively in men and in hot-humid climates. [3] [4]


Typically, over the upper inner thighs, there is an intensely itchy red raised rash with a scaly well-defined curved border. [3] [4] It is often associated with athlete's foot and fungal nail infections, excessive sweating, and sharing of infected towels or sports clothing. [4] [5] [6] It is uncommon in children. [4]

Its appearance may be similar to some other rashes that occur in skin folds including candidal intertrigo, erythrasma, inverse psoriasis and seborrhoeic dermatitis. Tests may include microscopy and culture of skin scrapings. [7]

Treatment is with topical antifungal medications and is particularly effective if symptoms have recent onset. [5] [6] Prevention of recurrences include treating concurrent fungal infections and taking measures to avoid moisture build-up including keeping the groin region dry, avoiding tight clothing and losing weight if obese. [8]


Other names include "jock rot", [9] "dhobi itch", [10] "crotch itch", [11] "scrot rot", [12] "gym itch", "ringworm of groin" and "eczema marginatum". [13]

Signs and symptoms

Typically, over the upper inner thighs, there is a red raised rash with a scaly well-defined border. There may be some blistering and weeping, and the rash can reach near to the anus. [3] The distribution is usually on both sides of the groin and the center may be lighter in colour. [8] The rash may appear reddish, tan, or brown, with flaking, rippling, peeling, iridescence, or cracking skin. [14]

If the person is hairy, hair follicles can become inflamed resulting in some bumps (papules, nodules and pustules) within the plaque. The plaque may reach the scrotum in men and the labia majora and mons pubis in women. The penis is usually unaffected unless there is immunodeficiency or there has been use of steroids. [4]

Affected people usually experience intense itching in the groin which can extend to the anus. [3] [4]


Macroconidia from Epidermophyton floccosum Macroconidia of Epidermophyton floccosum (PHIL 4207 lores).jpg
Macroconidia from Epidermophyton floccosum

Tinea cruris is often associated with athletes foot and fungal nail infections. [4] [5] Rubbing from clothing, excessive sweating, diabetes and obesity are risk factors. [6] [8] It is contagious and can be transmitted person-to-person by skin-to-skin contact or by contact with contaminated sports clothing and sharing towels. [3] [5]

The type of fungus involved may vary in different parts of the world; for example, Trichophyton rubrum and Epidermophyton floccosum are common in New Zealand. [7] Less commonly Trichophyton mentagrophytes and Trichophyton verrucosum are involved. [8] Trichophyton interdigitale has also been implicated. [5]


Tests are usually not needed to make a diagnosis, but if required, may include microscopy and culture of skin scrapings, a KOH examination to check for fungus, or skin biopsy. [3] [7]

Differential diagnosis

The symptoms of tinea cruris may be similar to other causes of itch in the groin. [3] Its appearance may be similar to some other rashes that occur in skin folds including candidal intertrigo, erythrasma, inverse psoriasis and seborrhoeic dermatitis. [7]


To prevent recurrences of tinea cruris, concurrent fungal infections such as athlete's foot need to be treated. Also advised are measures to avoid moisture build-up including keeping the groin region dry, avoiding tight clothing, and losing weight if obese. [8] People with athletes foot or tinea cruris can prevent spread by not lending their towels to others. [5]


Tinea cruris is treated by applying antifungal medications of the allylamine or azole type to the groin region. Studies suggest that allylamines (naftifine and terbinafine) are a quicker but more expensive form of treatment compared to azoles (clotrimazole, econazole, ketoconazole, oxiconazole, miconazole, sulconazole). [6] If the symptoms have been present for long or the condition worsens despite applying creams, terbinafine or itraconazole can be given by mouth. [5]

The benefits of the use of topical steroids in addition to an antifungal are unclear. [15] There might be a greater cure rate but no guidelines currently recommend its addition. [15] The effect of Whitfield's ointment is also unclear, [15] but when given, it is prescribed at half strength. [5]

Wearing cotton underwear and socks, in addition to keeping the groin dry and using antifungal powders, is helpful. [16]


Tinea cruris is not life-threatening and treatment is effective, particularly if the symptoms have not been present for long. [5] However, recurrence may occur. The intense itch may lead to lichenification and secondary bacterial infection. Irritant and allergic contact dermatitis may be caused by applied medications. [8]


Tinea cruris is common in hot-humid climates, and is the second most common clinical presentation for dermatophytosis. [8] It is uncommon in children. [4]

Related Research Articles

<span class="mw-page-title-main">Athlete's foot</span> Skin infection caused by fungus

Athlete's foot, known medically as tinea pedis, is a common skin infection of the feet caused by a fungus. Signs and symptoms often include itching, scaling, cracking and redness. In rare cases the skin may blister. Athlete's foot fungus may infect any part of the foot, but most often grows between the toes. The next most common area is the bottom of the foot. The same fungus may also affect the nails or the hands. It is a member of the group of diseases known as tinea.

<span class="mw-page-title-main">Terbinafine</span> Antifungal medication

Terbinafine, sold under the brand name Lamisil among others, is an antifungal medication used to treat pityriasis versicolor, fungal nail infections, and ringworm including jock itch and athlete's foot. It is either taken by mouth or applied to the skin as a cream or ointment. The cream and ointment are not effective for nail infections.

Dermatophyte is a common label for a group of fungus of Arthrodermataceae that commonly causes skin disease in animals and humans. Traditionally, these anamorphic mold genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera. Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota. As of 2019 a total of nine genera are identified and new phylogenetic taxonomy has been proposed.

<span class="mw-page-title-main">Tinea corporis</span> Medical condition

Tinea corporis is a fungal infection of the body, similar to other forms of tinea. Specifically, it is a type of dermatophytosis that appears on the arms and legs, especially on glabrous skin; however, it may occur on any superficial part of the body.

<span class="mw-page-title-main">Tinea capitis</span> Cutaneous fungal infection of the scalp

Tinea capitis is a cutaneous fungal infection (dermatophytosis) of the scalp. The disease is primarily caused by dermatophytes in the genera Trichophyton and Microsporum that invade the hair shaft. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern, that may be accompanied by inflammation, scaling, pustules, and itching. Uncommon in adults, tinea capitis is predominantly seen in pre-pubertal children, more often boys than girls.

<span class="mw-page-title-main">Intertrigo</span> Medical condition

Intertrigo refers to a type of inflammatory rash (dermatitis) of the superficial skin that occurs within a person's body folds. These areas are more susceptible to irritation and subsequent infection due to factors that promote skin breakdown such as moisture, friction, and exposure to bodily secretions and excreta such as sweat, urine, or feces. Areas of the body which are more likely to be affected by intertrigo include the inframammary fold, intergluteal cleft, armpits, and spaces between the fingers or toes. Skin affected by intertrigo is more prone to infection than intact skin.

<span class="mw-page-title-main">Ciclopirox</span> Antifungal medication

Ciclopirox is a synthetic antifungal agent for topical dermatologic treatment of superficial mycoses. It is most useful against tinea versicolor. It is sold under many brand names worldwide.

<span class="mw-page-title-main">Cradle cap</span> Human medical condition

Cradle cap or cradle hat causes crusty or oily scaly patches on a baby's scalp. The condition is not painful or itchy, but it can cause thick white or yellow scales that are not easy to remove. Cradle cap most commonly begins sometime in the first three months but can occur in later years. Similar symptoms in older children are more likely to be dandruff than cradle cap. The rash is often prominent around the ear, the eyebrows or the eyelids. It may appear in other locations as well, where it is called infantile seborrhoeic dermatitis. Cradle cap is just a special—and more benign—case of this condition. The exact cause of cradle cap is not known. Cradle cap is not spread from person to person (contagious). It is also not caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap often lasts a few months. In some children, the condition can last until age 2 or 3.

<span class="mw-page-title-main">Dermatophytosis</span> Fungal infection of the skin

Dermatophytosis, also known as ringworm, is a fungal infection of the skin. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. Multiple areas can be affected at a given time.

<span class="mw-page-title-main">Erythrasma</span> Medical condition

Erythrasma is a superficial skin infection that causes brown, scaly skin patches. It is caused by Corynebacterium minutissimum bacteria, a normal part of skin flora.

<span class="mw-page-title-main">Tinea manuum</span> Medical condition

Tinea manuum is a fungal infection of the hand, mostly a type of dermatophytosis, often part of two feet-one hand syndrome. There is diffuse scaling on the palms or back of usually one hand and the palmer creases appear more prominent. When both hands are affected, the rash looks different on each hand, with palmer creases appearing whitish if the infection has been present for a long time. It can be itchy and look slightly raised. Nails may also be affected.

<span class="mw-page-title-main">Butenafine</span> Chemical compound

Butenafine, sold under the brand names Lotrimin Ultra, Mentax, and Butop (India), is a synthetic benzylamine antifungal. It is structurally related to synthetic allylamine antifungals such as terbinafine.

<i>Trichophyton rubrum</i> Species of fungus

Trichophyton rubrum is a dermatophytic fungus in the phylum Ascomycota. It is an exclusively clonal, anthropophilic saprotroph that colonizes the upper layers of dead skin, and is the most common cause of athlete's foot, fungal infection of nail, jock itch, and ringworm worldwide. Trichophyton rubrum was first described by Malmsten in 1845 and is currently considered to be a complex of species that comprises multiple, geographically patterned morphotypes, several of which have been formally described as distinct taxa, including T. raubitschekii, T. gourvilii, T. megninii and T. soudanense.

<i>Trichophyton</i> Genus of Fungi

Trichophyton is a genus of fungi, which includes the parasitic varieties that cause tinea, including athlete's foot, ringworm, jock itch, and similar infections of the nail, beard, skin and scalp. Trichophyton fungi are molds characterized by the development of both smooth-walled macro- and microconidia. Macroconidia are mostly borne laterally directly on the hyphae or on short pedicels, and are thin- or thick-walled, clavate to fusiform, and range from 4 to 8 by 8 to 50 μm in size. Macroconidia are few or absent in many species. Microconidia are spherical, pyriform to clavate or of irregular shape, and range from 2 to 3 by 2 to 4 μm in size.

Whitfield's ointment is an acidic ointment used for the topical treatment of dermatophytosis, such as athlete's foot. It can have a slight burning effect that goes away after a few minutes. It is named after Arthur Whitfield (1868–1947), a British dermatologist.

Trichophyton concentricum is an anthropophilic dermatophyte believed to be an etiological agent of a type of skin mycosis in humans, evidenced by scaly cutaneous patches on the body known as tinea imbricata. This fungus has been found mainly in the Pacific Islands and South America.

<i>Epidermophyton floccosum</i> Species of fungus

Epidermophyton floccosum is a filamentous fungus that causes skin and nail infections in humans. This anthropophilic dermatophyte can lead to diseases such as tinea pedis, tinea cruris, tinea corporis and onychomycosis. Diagnostic approaches of the fungal infection include physical examination, culture testing, and molecular detection. Topical antifungal treatment, such as the use of terbinafine, itraconazole, voriconazole, and ketoconazole, is often effective.

Two feet-one hand syndrome(TFOHS), is a long-term fungal condition where athlete's foot or fungal toe nail infections in both feet is associated with tinea manuum in one hand. Often the feet are affected for several years before symptoms of a diffuse scaling rash on the palm of one hand appear, which is when most affected people then seek medical help.

Topical antifungaldrugs are used to treat fungal infections on the skin, scalp, nails, vagina or inside the mouth. These medications come as creams, gels, lotions, ointments, powders, shampoos, tinctures and sprays. Most antifungal drugs induce fungal cell death by destroying the cell wall of the fungus. These drugs inhibit the production of ergosterol, which is a fundamental component of the fungal cell membrane and wall.


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