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What is Jock Itch ?
Jock itch is an infection caused by
fungus and affects the groin, upper thighs and buttocks. It is
also called as tinea cruris (medical name). The fungus that most
commonly cause this is Trichophyton rubrum. The fungus when seen
under a microscope looks like a translucent, rod-shaped
filaments or hyphae. The filament or hyphae is straight at the
beginning and tapers at the end distinguishing itself from hair.
It is closely related to other tinea skin infections such as
tinea capitis, which is the ringworm of the scalp; tinea pedis,
which is athlete’s foot and tinea corporis, which is ringworm of
the body. The rashes that appear due to Jock itch are similar to
other rashes of the groin such as intertrigo which is mostly
seen in obese patients ad caused by moist skin rubbing against
moist skin. The skin breaks down in lines called fissures, which
are very painful.
Causes
Every body have microscopic bacteria and fungi that hosts on our
body. Dermatophytes are one among them. They live on the dead
tissues of the skin, nails etc and thrive on moist and warm
areas. When the areas around the groin sweat and are not dried
properly these fungi multiply and thrives on them. Jock itch is
characterised by red, itchy and often ring shaped rashes. The
rash starts in the groin region on both the sides and sometimes
continues to the lower thighs. Jock itch can affect anybody who
sweats a lot and mostly affects the men. It is named Jock itch
because it is seen mostly in jocks or athletes. Jock itch is
mildly contagious and can spread by sharing clothes such as
towels etc with someone who has infection and also through
direct sexual contact.
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Signs
and symptoms
Jock itch is actually less dangerous compared to other skin
infections, but can remain for longer periods when left without
treated. The symptoms of Jock itch include the following:
•Flaking or cracking of the skin.
•Ring shaped red coloured rash with elevated edges.
•Burning sensation around the groin.
•Itching sensation around the groin area including inner thighs,
genitals, buttocks and anal areas.
•Redness of the skin around groin, thigh and anal areas.
•The scrotum and penis are usually less affected. |
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Diagnosis
The diagnosis done for Jock itch is usually through KOH test. It
is mainly involved in looking for the filaments or hyphae under
a microscope. Generally, the part of the skin affected is
scraped with a glass slide making the dead cells to fall on it.
After that a few drops of potassium hydroxide or KOH is added to
the slide and is heated for some time. This is done because the
potassium hydroxide will dissolve the material that is attached
to the skin cells releasing the filaments without even
distorting the cell or the filament. The filaments are seen
better using ceratin special stains such as Parker’s blue ink,
Chlorazol fungal stain, Swartz Lamkins Fungal stain etc. If the
test done using microscope gives negative results, then the
sample is taken for further studies to the laboratory where in
it is checked whether the sample will grow the fungi under right
conditions. This is called culture. This test is performed even
when some treatments given by the doctor has failed.
Treatment
If the infection is mild then it is best treated with antifungal
drugs such as topical creams, ointments or sprays. Since the
fungus affects only the top layer of the skin it is easy to
treat. Over the counter antifungals that are prescribed include
miconazole (Micatin), tolnaftate (Tinactin) and clotrimazole
(Lotrimin). If the treatment does not respond to the above
medications, then topical medicines given are Oxiconazole (Oxistat)
and Econazole (Spectazole) and oral medicines include
Fluconazole (Diflucan), Terbinafine (Lamisil) and Itraconazole (Sporanox).
Steroids are advised to be avoided in the groin region because
it can worsen the situation. The creams must be applied at least
two weeks or still the rash disappears. Jock itch is usually
associated with athlete’s foot.
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These antifungal agents work by
stopping the fungi from producing ergosterol. Ergosterol is a
substance that is an essential component of fungal cell
membranes. If the synthesis of ergosterol is completely stopped,
then the cell can no longer construct an intact cell membrane,
which leads to death of the fungus. If during the treatment i.e.
during the course of using the topical creams, the patient
suffers from itching and discomfort, then glucocorticoid
steroids can be combined with antifungal drug to help prevent
irritation and scratching of the affected area. But it is
important to note that the steroids must not be used alone on
the affected areas.
Some of the side effects that include
with oral medicines are
• Rash.
• Abnormal liver functioning.
• Gastrointestinal upset.
• Alter the effectiveness of warfarin (anticoagulant drug that
decreases the clotting ability of the blood). |
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Presently doctors are also prescribing
griseofulvin (Fulvicin, Grisactin) which is introduced newly in the
market. This is an oral infection prescribed to treat the fungus but
takes a long period to clear the infection. The side effects of the
drug include headache, drop in the white blood cell count, rash,
discomfort in the digestive tract, sensitivity to light etc. This is
useful for people who are not comfort with other medications.
Prevention
All infections can mostly prevent from being hygienic. Following are
the measures that have to be taken to prevent Jock itch:
• Wash the affected area with soap and water and dry the area
completely. Use talcum powder or medicated powders to keep the groin
area dry. If you are using water instead of toilet paper, then hair
dryer is helpful since it can even prevent skin damage.
• Bathe everyday especially after sport activities and exercising.
• Application of the creams, sprays must be put directly on the
affected areas.
• Sharing of the clothes like towel etc must be avoided.
• Under wears must be changed regularly to prevent the infection
from spreading and helping it to heel faster.
• Clothes worn must be loose fitting and cotton material to absorb
the moisture from the body.
• Clothes such as under wears and bed spreads must be washed in hot
water especially one which is worn for exercise, workouts etc.
• Should be careful while storing the clothes. It must not be stored
in damp, moist areas, in dark places and in places with poor
ventilation.
• While putting and taking off pants one must be careful since the
feet can transfer the fungus to the crotch and viceversa.
• Treatment course must be completely taken as advised by the
doctor.
• If the infection persists consult the doctor immediately.
• Avoid having sexual intercourse with the person who is affected
with Jock itch.
• Certain materials such as scented or antibacterial soaps can
aggravate the infection. Try using hypoallergenic or candila soaps.
• Exercises such as cycling which causes sweating and friction can
help in growth of the fungi. It is important to shave the hair
regularly. Though the infection is considered not to be severe or
dangerous it is difficult for people with weak immune systems such
as diabetes and HIV infected to get rid of such infections.
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Article Contributed By: Shilpa V
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