Jock itch
Encyclopedia
Tinea cruris, also known as crotch itch, crotch rot, Dhobie itch, eczema marginatum, gym itch, jock itch, and ringworm of the groin in American English is a dermatophyte
Dermatophyte
Dermatophytes are a common label for a group of three types of fungus that commonly causes skin disease in animals and humans. These anamorphic genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera...

 fungal infection
Mycosis
A mycosis is a fungal infection of animals, including humans. Mycoses are common, and a variety of environmental and physiological conditions can contribute to the development of fungal diseases...

 of the groin
Groin
In human anatomy, the groin areas are the two creases at the junction of the torso with the legs, on either side of the pubic area. This is also known as the medial compartment of the thigh. A pulled groin muscle usually refers to a painful injury sustained by straining the hip adductor muscles...

 region in either sex, though more often seen in males. In the German
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...

 Sprachraum
Sprachraum
Sprachraum is a linguistic term used to designate a geographical region/district where a language, dialect, group or family of languages is spoken. The German word Sprachraum literally means "language area"....

 this condition is called Tinea inguinalis (from Latin inguen = groin
Groin
In human anatomy, the groin areas are the two creases at the junction of the torso with the legs, on either side of the pubic area. This is also known as the medial compartment of the thigh. A pulled groin muscle usually refers to a painful injury sustained by straining the hip adductor muscles...

) whereas Tinea cruris is used for a dermatophytosis of the lower leg (Latin crus).

Candidal intertrigo is an infection of the skin by Candida albicans
Candida albicans
Candida albicans is a diploid fungus that grows both as yeast and filamentous cells and a causal agent of opportunistic oral and genital infections in humans. Systemic fungal infections including those by C...

, more specifically located between intertriginous
Intertriginous
Intertriginous is a medical term used to define an area where two skin areas may touch or rub together. Examples of intertriginous areas are the axilla of the arm, the anogenital region, nares, skin folds of the breasts, and between digits...

 folds of adjacent skin, which can be present in the groin or scrotum, and be indistinguishable from fungal infections caused by Tinia. However, candidal infections tend to both appear and disappear with treatment more quickly.

Symptoms and signs

As the common name for this condition implies, it causes itch
Itch
Itch is a sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to classify it as any one type of sensory experience. Modern science has shown that itch has many similarities to pain, and while both are unpleasant sensory experiences, their behavioral response...

ing or a burning sensation in the groin area, thigh skin fold
Skin fold
Skin folds are areas of skin where it folds. Many skin folds are distinct, heritable anatomical features, and may be used for identification of animal species, while others are non-specific and may be produced either by individual development of an organism or by arbitrary application of force to...

s, or anus. It may involve the inner thighs and genital areas, as well as extending back to the perineum
Perineum
In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...

 and perianal areas.

Affected areas may appear red, tan, or brown, with flaking, rippling, peeling, or cracking skin.
The acute infection begins with an area in the groin fold about a half-inch across, usually on both sides. The area may enlarge, and other sores may develop in no particular pattern. The rash appears as raised red plaques (platelike areas) and scaly patches with sharply defined borders that may blister and ooze.

If the rash advances, it usually advances down the inner thigh. The advancing edge is redder and more raised than areas that have been infected longer. The advancing edge is usually scaly, and very easily distinguished or well demarcated.

The skin within the border turns a reddish-brown and loses much of its scale. The border may exhibit tiny pimple
Pimple
A pimple, zit or spot is a kind of acne, and one of the many results of excess oil getting trapped in the pores. Some of the varieties are pustules or papules....

s or even pustules, with central areas that are reddish and dry with small scales.

If infected with candidal organisms, the rash tends to be redder and wetter. The skin of the penis
Penis
The penis is a biological feature of male animals including both vertebrates and invertebrates...

 may be involved, whereas other organisms spare the penis.

Causes

Opportunistic infection
Opportunistic infection
An opportunistic infection is an infection caused by pathogens, particularly opportunistic pathogens—those that take advantage of certain situations—such as bacterial, viral, fungal or protozoan infections that usually do not cause disease in a healthy host, one with a healthy immune system...

s (infections that are caused by a diminished immune system
Immune system
An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...

) are frequent. Fungus
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...

 from other parts of the body (commonly tinea pedis or 'athlete's foot') can contribute to jock itch. A warm, damp environment allowing the fungus to cultivate greatly contributes; especially with tight, sweaty or rubbing clothing such as a jockstrap
Jockstrap
A jockstrap is an undergarment designed for supporting the male genitalia during sports or other vigorous physical activity...

.

The type of fungus that most commonly causes tinea cruris is called Trichophyton rubrum
Trichophyton rubrum
Trichophyton rubrum is a fungus that is the most common cause of athlete's foot, jock itch and ringworm. This fungus was first described by Malmsten in 1845....

. Some other contributing fungi are Candida albicans
Candida albicans
Candida albicans is a diploid fungus that grows both as yeast and filamentous cells and a causal agent of opportunistic oral and genital infections in humans. Systemic fungal infections including those by C...

, Trichophyton mentagrophytes and Epidermophyton floccosum
Epidermophyton floccosum
Epidermophyton floccosum is an anthropophilic dermatophyte which can be found world-wide.-Taxonomy:The fungus was originally described by Carl Otto Harz in 1870, who named it Acrothecium floccosum...

.

Prevention

Medical professionals suggest keeping the groin area clean and dry by drying off thoroughly after bathing and putting on dry clothing right away after swimming or perspiring.

Other recommendations are: not sharing clothing or towels with others, showering immediately after athletic activities, wearing loose cotton underwear, avoiding tight-fitting clothes, and using antifungal powders.

Treatment

Tinea cruris is best treated with topical antifungal medications of the allylamine or azole type. These anti-fungal agents stop fungi from producing ergosterol
Ergosterol
Ergosterol is a sterol found in fungi, and named for ergot, a common name for the members of the fungal genus Claviceps from which ergosterol was first isolated. Ergosterol does not occur in plant or animal cells...

, an essential component of fungal cell membranes. If ergosterol synthesis is completely or partially inhibited, the fungal cell is unable to construct an intact cell membrane, and dies. Allylamines and thiocarbamate antifungals (tolnaftate
Tolnaftate
Tolnaftate is a synthetic over-the-counter anti-fungal agent. It may come as a cream, powder, spray, or liquid aerosol, and is used to treat jock itch, athlete's foot and ringworm. It is sold under several brand names, most notably Tinactin and Odor Eaters . Other brands are Absorbine, Aftate,...

, Tinactin etc.) and are effective against Tinea cruris, but not against Candida albicans
Candida albicans
Candida albicans is a diploid fungus that grows both as yeast and filamentous cells and a causal agent of opportunistic oral and genital infections in humans. Systemic fungal infections including those by C...

, which requires an azole type drug, making azole drugs, effective against both types of infections, the first choice for topical treatment of infections of unknown etiology in intertriginous
Intertriginous
Intertriginous is a medical term used to define an area where two skin areas may touch or rub together. Examples of intertriginous areas are the axilla of the arm, the anogenital region, nares, skin folds of the breasts, and between digits...

 areas.

If the skin inflammation causes discomfort and itching, glucocorticoid
Glucocorticoid
Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor , which is present in almost every vertebrate animal cell...

 steroid
Steroid
A steroid is a type of organic compound that contains a characteristic arrangement of four cycloalkane rings that are joined to each other. Examples of steroids include the dietary fat cholesterol, the sex hormones estradiol and testosterone, and the anti-inflammatory drug dexamethasone.The core...

s (such as 1% hydrocortisone cream) may be combined with the anti-fungal drug to help prevent further irritation due to the patient scratching the area. Apart from the quicker relief of symptoms, this also helps minimize the risk of secondary bacterial infection caused by the scratching. However, steroids may exacerbate the condition if used alone for fungal infections because they hinder the body's immune system.

Since fungi tend to thrive in warm, dark, damp conditions, minimizing these conditions can help treat and prevent jock rash. Some useful measures are: wearing boxer underwear or no underwear, increasing air-flow by sleeping near a fan, wearing loose sleepwear or no sleepwear, exposing the area to wind and sun, and thoroughly cleaning the area with a hand-held shower head and soap.

See also

  • List of cutaneous conditions
  • Pruritus ani
    Pruritus ani
    Pruritus ani is the irritation of the skin at the exit of the rectum, known as the anus, causing the desire to scratch. The intensity of anal itching increases from moisture, pressure, and rubbing caused by clothing and sitting...

  • Swimwear and hygiene
  • Tinea
    Tinea
    Tinea is a general term used to describe skin mycoses. The term ringworm is even less precise, but is usually considered a synonym.It is sometimes equated with dermatophytosis, and it is true that most conditions identified as "tinea" are members of the imperfect fungi that make up the dermatophytes...

  • Tinea corporis gladiatorum
    Tinea corporis gladiatorum
    Tinea corporis gladiatorum is a dermatophytic infection present in wrestlers, with skin lesions typically found on the head, neck, and arms....


External links

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