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HomeAnswersDermatologyjock itchMy aunty noticed a blackish discoloration over her back. What is it?

What are the symptoms of tinea cruris infection?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At November 17, 2022
Reviewed AtJanuary 15, 2024

Patient's Query

Hello doctor,

My aunty got an infection over her back for three months. As a result, I have a history of blackish discoloration over the back. I attached the images, and I do not have any history of diabetes mellitus or hypertension. Please help.

Hello,

Welcome to icliniq.com.

I understand your concern.

I have reviewed the history provided from your end and have viewed the image (the attachments are removed to protect the patient's identity). It appears to be Tinea cruris.

Tinea cruris is a fungal infection that affects the skin, especially along the folds or unexposed areas of the body also affects the private areas, buttocks, folds under the abdomen, folds underarms, and folds behind the knee joint, which are most often caused due to stagnation of moisture and stagnation of sweat over the folds and unexposed areas of the body. Other causes of the same include direct contact or sharing of belongings of an infected person and due to lowered immunity, climate factors when there are extreme changes in climates they may trigger the formation of this infection, dietary factors and following an imbalanced diet and also due to some underlying medical condition which can be ruled out at this point since you have already mentioned that your aunt is free from any comorbidities.

Tinea infection is characterized by white, skin-colored, red, or black-colored lesions that are well circumscribed and usually consist of silvery white scales on top. They may be small in size initially, which spreads and increases in size eventually. They may present with excessive itching throughout the day and sometimes, which are also aggravated during sweating. They may also lead to a slight burning sensation, oozing of secretions, pain, and irritation in some individuals and may also cause a light burning sensation while applying medication. They may also easily spread from one area to another and increase in size, especially if left untreated for a long time. They may also spread from one person to another if adequate precautions are not maintained.

Tinea infection may occur on and off depending on the external triggers, as mentioned above. It may require months together for complete remission since, as per the image provided, It has been a longstanding infection and has spread in the unexposed areas. Considering the location of the infection as well as the severity and spread of the infection, It may take a few months for remission; therefore, consistency with the medication is key.

I suggest,

1. Ketoconazole soap twice daily may be used during bathing twice daily. It is advised to lather the soap and water and apply the other on the affected area only twice daily; massage in the affected area for a minute, leave the ladder on the affected area for three minutes, and then wash off. This may be continued for months together till the rashes start fading. It is also to be noted that the unaffected areas of the skin may be washed and cleaned with regular soap. It also needs to be made sure not to share the antifungal soap I have mentioned and your regular soap with other individuals or family members at home.

2. Terbinafine 1 % cream may be applied twice daily on the affected area only in the morning and at night. A generous amount of cream may be applied to the affected area only after cleaning the area with the soup and double dry ingredients well to remove any present moisture. They may be applied, massaged into the affected area, and kept intact until the next wash. It is also advised to clean and wash your fingers after application well. This cream can be continuously applied for months until the lesions fade.

3. Terbinafine dusting powder may be used between the applications of cream in the afternoon and the evening only affected area. They help absorb the moisture and sweat that remains stagnant within the area throughout the day and also help reduce the buildup of the fungal elements within the affected area, thereby reducing the chances of further spread and reducing the current lesion. This may also be continued for months together.

4. Capsule Itraconazole 200 mg may be taken orally once daily after dinner for four weeks. This is an antifungal capsule that can be taken, which helps in reducing the spread of the current lesions and reducing the current lesion as well. They may even be continued for up to 12 weeks depending upon the progress for which I would like to advise you to revert as a follow-up after one month to provide the details of further management and dosage of the same capsule and the duration of the intake of the capsule as well.

5. Tablet Cetirizine 10 mg may be taken one hour before going to sleep daily for one week. They help in reducing itching. This medication is slightly sedative. It is suggested not to drive or go out after taking the medication.

6. Capsules Becosules Z ( vitamin C, zinc, and vitamin D) can be taken orally in the morning after breakfast for one month. This is a multivitamin capsule consisting of vitamin C, vitamin D, and zinc which helps in strengthening immunity and reducing the recurrence of the infection.

As may be noted above, all the medications in the form of oral as well as topical medications are provided In their generic names except for the Becosules Z capsule, of which the contents are also provided in brackets. Therefore, any brand name with the generic name which has been mentioned above may be purchased depending on the availability in your country of residence.

7. Avoid stagnation of moisture and sweat on the affected area as well as other private areas, as stagnation of moisture, as well as sweat, would result in increasing and spreading of the lesion due to the buildup of fungal elements. Following a bath, it needs to be ensured that the affected area is well-dried using a towel.

8. It is also suggested to air the area well, especially private areas, on a daily basis for at least 10 minutes under a fan. Also, it is best to wear loose-fitting clothes so that there is more airing in the area.

9. Make sure to have a balanced diet, including avoiding oily and fried food, sweets, red meat, milk, and dairy products, as they may aggravate the fungal buildup. Make sure to include more fruits, vegetables, fiber, and at least 12 glasses of water on a daily basis in a 250 mL glass size.

10. At-home remedies, including using lukewarm salt water to wash the area, may be very beneficial as they may help in reducing the buildup of fungal elements in the area and prevent their spread as well. Apart from the same mild scrubbing of the affected area very gently without causing any abrasions or wounds, the affected area may be done once daily during bathing in order to lessen the thickness of the area which causes a reduction in the buildup of the fungal elements, thereby causing a disruption in the spreadability of the fungal elements present in the area

11. There are also tests that may be conducted before starting these medications for a confirmative diagnosis, including KOH (Potassium hydroxide) fungal scraping test in which the skin scales which are present on the affected area are scraped for testing in order to reach a confirmatory diagnosis as well.

As I have mentioned above, Tinea cruris infection, depending upon the location and spread, will take months together for reducing in appearance. Therefore consistency with the medication is key as the main idea of using medications, be it oral or topical, and home remedies are to reduce the current fungal element buildup as well as to prevent their spread to other areas as well. It also needs to be noted that maintenance of good immunity and a balanced diet is also essential in order to prevent further recurrence of the same infection. In case of any other family members who are affected with the same infection, it is advised to have them treated as well in order to prevent recurrence among family members as well.

Hope the details provided above the informative and provided clarity. In case the test that I have mentioned is being done, I would like to request you to provide the report of the same.

I hope you find it helpful.

Kind regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sandhya Narayanan Kutty
Dr. Sandhya Narayanan Kutty

Venereology

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