A 20yrs old male patient presented with multiple, red colored, itchy annular lesion with scales from past 4wks.

Patient presented with multiple red, itchy annular scaly lesions over the groins and the adjoining areas along with few annular lesions present over the abdomen and chest since 4 wks. Lesions are increasing in size with central clearing and peripheral spreading. Lesions in the groins have coalesced and enlarged in size. 

From the history and examination the diagnosis is Tinea cruris with Tinea corporis.

Dermatophytic infections of skin are a major health related problem and lead to decreased quality of life. Tinea corporis is mainly caused by T. rubrum. The organism responsible for tinea corporis invades the stratum corneum, possibly aided by warm, moist and occlusive conditions, and resides in it.  This patient presented with multiple lesions on the chest, abdomen and groins. 

Patient was advised Tab Terbinafine 250mg once daily for 6wks and topical luliconazole for 4wks. Till 4 months after the initiating dusting powder no relapse was seen. Superficial fungal infections are usually caused due to hot and humid environment and direct skin to skin contact. Relapse of infection is a major concern. So some dusting powder must be given to the patient after completion of initial therapy.

Treatment for superficial fungal infections includes topical and systemic antifungals. The duration of treatment depends on the site of involvement and the drug chosen for treatment. An important mechanism of host defense against these pathogens is the keratinization which is the process of epithelial desquamation leading to removal of the fungus.  Resistance to antifungals have been reported in the past and relapse is also a major concern. 

Luliconazole is an imidazole antifungal agent that has been shown to have potent activity against a variety of fungi, especially dermatophytes.