Some important definitions ...Fungal skin infections can present as tinea capitis, tinea pedis, tinea corporis, tinea cruris, and Majocchi's granuloma. The names are confusing but these infections are named after the site of primary involvement. Tinea capitis is a fungal infection of the scalp, eyebrows, or eyelashes. Tinea pedis is a fungal infection of the interdigital areas and soles of the feet. Tinea corporis, also known as superficial fungal infection involves the skin. Tinea cruris is a fungal infection of the genital area, inner thighs, and buttocks. Majocchi's granuloma is an altered cutaneous fungal infection. It begins like any of the above infections but because of the application of topical steroids and other creams, the classical appearance and presentation are not found.
Let's discuss the Treatment of fungal skin infections of our patient ...This is 50 years of age male patient with no previous comorbid conditions. He presented with this rash on the lower abdomen and genital area. you can see a central clearing with scaly edges that are spreading. The skin looks thin and peppery that may be indicative of the use of topical steroids. There is also a yellow scab that may be indicative of bacterial superinfection. So yes, after inquiring about the patient, he has been applying all sorts of creams over these lesions and gets temporary relief.
My concerns were:
Is the patient immunocompromised?
Is he treating it with steroids?
I advised the patient to stop all the topical creams. His random blood glucose was checked that was within the normal range.
Since the lesions were extensive, I prescribed him topical as well as oral terbinafine for two weeks.He is to follow me after 2 weeks. I will try to post the new pics after treatment. Hopefully, the lesions will regress, although, I may extend the treatment. I also plan to arrange a dermatologist consultation as well especially, if the lesions do not improve.