Abstract

A 17-year-old male was diagnosed with tinea cruris. He was treated with topical eberconazole and oral itraconazole which led to significant improvement in the condition of the patient.

Introduction

Tinea cruris, also known as jock itch is a fungal infection affecting the groin region and both the thighs. However, the penis and scrotum are not usually involved.¹ The current case is of a patient with tinea cruris who was treated well with topical eberconazole and oral itraconazole.

Case presentation

A 17-year-old male presented with a chief complaint of red colored rashes in the groin and thighs since 3 months. 

History

The patient mentioned that the lesions were initially present on the thighs and later on involved the groin region. They were associated with itching. He had taken over the counter topical medications by asking a chemist. However, no improvement occurred.

Examination

On examination, hyperpigmented lichenified scaly plaques could be seen on the thighs and groin. The penis and scrotum were spared.

Provisional diagnosis

No investigations were ordered and the diagnosis of tinea cruris was formulated on the basis of clinical findings.

Management

The patient was given topical eberconazole cream 1% to be applied twice a day for 15 days. In addition, he was prescribed oral itraconazole twice daily for 15 days. He was asked to keep the affected area clean and completely dry. The therapy helped in improving the lesions remarkably. Topical eberconazole was continued for another 15 days after which the patient was lost to follow-up. 

Discussion

Eberconazole, an agent belonging to the class of imidazoles, exerts fungicidal or fungistatic effect, depending on the concentration. At lower concentrations, it acts as a fungistatic while at higher concentrations as a fungicidal. It prevents the growth of fungi by inhibiting fungal lanosterol 14α-demethylase. In addition, it presents an advantage over other agents of its class in the form of anti-inflammatory action. Due to this property, eberconazole can be employed for managing inflamed dermatophytic infections. Several studies have suggested the efficacy of this agent in the treatment of dermatophytosis. According to a double-blind study that compared eberconazole 1% cream with miconazole, eberconazole displays similar therapeutic efficacy and safety profile as that of miconazole. After 1 month of therapy, 76.09% and 75% patients reported efficacy in eberconazole and miconazole groups, respectively.² 

Itraconazole, a triazole antifungal also shows a broad spectrum of activity against a wide range of superficial fungal infections including difficult-to-treat dermatophytosis.³ various studies indicate the efficacy of this agent in the treatment of dermatophytic infections. The findings of a double-blind study showed the effectiveness of oral itraconazole 100mg administered once daily in the treatment of patients with tinea cruris and tinea corporis.⁴ Therefore, these agents appear to be viable options for the treatment of dermatophytosis.

References

1. Weinstein A, Berman B. Topical treatment of common superficial tinea infections. Am Fam Physician 2002;65:2095-102.
2. Bangera LS, Martis J, Mittal R, et al. Eberconazole-Pharmacological and clinical review. IJDVL. 2012;78(2):217-222.
3. Piérard GE, Arrese JE, Piérard-Franchimont C. Itraconazole. Expert Opin Pharmacother. 2000 Jan;1(2):287-304.
4. Pariser DM, Pariser RJ, Ruoff G, et al. Double-blind comparison of itraconazole and placebo in the treatment of tinea corporis and tinea cruris. Journal of the American Academy of Dermatology. 1994;31(2 Pt 1):232-234.