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Fungal Body and Groin - Coggle Diagram
Fungal Body and Groin
Management
If an adult has severe or extensive disease, consider prescribing oral antifungal treatment if there is positive skin sample, or a strong clinical suspicion of fungal skin infection.
Terbinafine is first-line treatment in Primary care. Consider prescribing oral itraconazole or oral griseofulvin if terbinafine is not tolerated or is contraindicated.
Consider prescribing a mildly-potent topical corticosteroid in addition, if there is associated marked inflammation, such as Hydrocortisone 1% once daily for a maximum of 7 days.
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Advise treatment with a topical antifungal cream if there is mild, non-extensive disease in children and adults.
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Diagnosis
Single or multiple red or pink, flat or slightly raised annular (ring-shaped) patches of varying sizes (usually 1–5 cm) which enlarge outwards.
Typically, lesions have an active red, scaly advancing edge and a clear central area (so-called 'central clearing').
History of scaly, itchy skin in the affected areas
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On examination of the groin(s) there may be: Involvement most commonly affecting the inguinal folds and proximal medial thighs. The perianal skin, buttocks, and above the waistline may also be affected. In men, the penis and scrotum are often spared. Skin lesions which are commonly red to red-brown, flat or slightly raised plaques with active borders (may be pustules or vesicles within lesions). Uniform scale without central clearing, and the typical scaly edge may be lost in moist flexures.
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More rarely, numerous overlapping concentric circles (tinea imbricate) or herpetiform subcorneal vesicles or pustules (bullous tinea corporis).
Assessment
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Ask about - nature, site, duration of symptoms
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Examination - pattern, extent, severity of infection, associated inflammation, complications, associated fungal infection at other sites.
Diagnostic tests are not normally required but arrange skin sampling if severe/extensive disease in adults or diagnosis is uncertain/atypical appearance.
Risk factors
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Hot, humid climates or working in high temperature environments
Definition: Fungal infections of the body and groin are also known as 'tinea corporis' or 'ringworm', and 'tinea cruris'. Infection is usually transmitted by direct contact with infection person/animal, indirect contact with fomites or contact with the soil.