Tinea Versicolor in the Groin Region: Diagnosis and Treatment
Yes, tinea versicolor (pityriasis versicolor) can occur in the groin region and should be treated with topical antifungal medications similar to dermatophyte infections, though with recognition of its distinct causative organism. 1, 2
Pathophysiology and Presentation
- Tinea versicolor is a common fungal infection caused by Malassezia species (formerly Pityrosporum orbiculare), presenting as hyperpigmented or hypopigmented macules with fine scale 3
- While typically affecting the chest, upper back, and shoulders, tinea versicolor can appear in uncommon locations including the groin region 1
- In the groin, tinea versicolor may clinically mimic erythrasma (a bacterial infection caused by Corynebacterium minutissimum) or dermatophyte infections like tinea cruris 2, 4
Diagnostic Approach
- Wood's lamp examination can be helpful in distinguishing tinea versicolor (yellowish-white or copper-orange fluorescence) from erythrasma (coral-pink fluorescence) 3, 4
- Microscopic examination of skin scrapings with potassium hydroxide (KOH) preparation reveals characteristic "spaghetti and meatballs" appearance (short hyphae and round yeast cells) 5
- Culture is generally not necessary but can be performed on Sabouraud agar to confirm the diagnosis 5
Treatment
- Topical antifungal therapy is the first-line treatment for tinea versicolor in the groin, with ketoconazole 2% cream being FDA-approved for this indication 6
- Apply ketoconazole cream once daily to cover the affected and immediately surrounding area for two weeks to reduce the possibility of recurrence 6
- Other effective topical options include:
Special Considerations
- Recurrence is common with tinea versicolor, requiring maintenance therapy in some cases 8
- For extensive, resistant, or recurrent infections, oral antifungal therapy may be necessary 7
- In immunocompromised patients, fungal infections including tinea versicolor may be more widespread and difficult to treat 9
- Differential diagnosis in the groin region must include:
Prevention of Recurrence
- Avoid excessive heat and humidity when possible 10
- Wear loose-fitting, breathable clothing 10
- Keep the groin area clean and dry 10
- For patients with recurrent infections, prophylactic use of antifungal shampoo or cream may be beneficial 7
Remember that while tinea versicolor and dermatophyte infections (like tinea cruris) may appear similar and respond to similar treatments, they are caused by different organisms - Malassezia species for tinea versicolor versus Trichophyton, Microsporum, or Epidermophyton species for dermatophyte infections 6, 7.