Unresolved tinea cruris

A 37 year old man was seen for generalised pruritus for a year. He has seen few GPs but the lesions never cleared.

Clinical exam showed large discrete erythematous macules with well defined raised margin on the cervical region and the inguinal area. There was central clearing on the neck lesion.

A bedside KOH preparation showed presence of hyphae.

I find bedside KOH prep to be very useful in practice. Once confirmed, I would treat with either a topical antifungal or an oral antifungal agent. In this case I used oral terbinafine 250mg daily for 2 weeks.

The skin scrappings were also sent for culture. This is important to identify the dermatophyte involved.

I am at the moment doing a small research study on the prevalence of dermatophyte infection in my clinic. The results of this study would be interesting and useful for epidemiology of superficial fungal infection in Perak region.