Inguinal epidermophytosis is a lesion of the epidermis of fungal etiology that occurs in large folds of the skin. It is manifested by typical flaky pink spots with a clean center and a periphery covered with vesicles and pustules. It is most often localized in the inguinal folds. The diagnosis of inguinal epidermophytosis confirms the detection of mycelium of the fungus by microscopy of scales from the surface of spots and the growth of characteristic colonies during a culture study. Treatment is carried out with antihistamines and external antifungal drugs.
Men are more likely to suffer from inguinal epidermophytosis. In adolescents and children, it is extremely rare. Inguinal epidermophytosis refers to fungal diseases or dermatomycosis. Its pathogens are fungi Epidermophyton floccosum, Trichophyton mentagrophytes, Trichophyton rubrum, infection of which occurs by contact and household means. The transmission of fungi can be through bedding, towels, linen, washcloths, with disregard for the rules of personal hygiene in the bath, pool, shower. Walking in a bath or public shower without bath slippers is fraught with infection with inguinal epidermophytosis with rare, but occurring, localization on the feet and nails.
Factors that favor infection include: high ambient temperature, high humidity, increased sweating, damage to the surface layer of the skin (scratches, small abrasions, maceration), obesity, in which hygienic skin care in large folds is difficult.
Inguinal epidermophytosis begins with the appearance of pink itchy spots up to 1 cm in size. The spots have a rounded shape and a flaky surface. Due to their peripheral growth, they gradually increase, reaching a diameter of up to 10 cm. Such lesions have clearly delineated scalloped edges. On their periphery, on a hyperemic background, there are multiple pustules and vesicles. At the same time, the inflammation in the center of the spot subsides, leaving behind clean skin, which gives the foci of inguinal epidermophytosis a characteristic appearance of rings. The patient is concerned about severe itching, discomfort while walking.
The most typical localization of inguinal epidermophytosis, as the name suggests, is the inguinal folds. But the fungus can also affect the skin of the inner surface of the thighs, the interdigital fold and the axillary areas. Sometimes the process spreads to the skin in the anus and can occur in the interdigital spaces on the feet. Occasionally, men have a lesion of the scrotum, women have folds under the mammary glands. Nails are less often affected.
In the absence of adequate therapy, inguinal epidermophytosis can last up to several years. If it is caused by Trichophyton mentagrophytes, it is characterized by an acute course with a pronounced inflammatory reaction. For inguinal epidermophytosis caused by the fungi Trichophyton rubrum and Epidermophyton floccosum, a less acute course is typical and, with sufficient duration of the disease, alternating periods of remission and exacerbation.
The diagnosis of inguinal epidermophytosis is established by a dermatologist or mycologist. To confirm the etiology of the disease, a study of scraping for pathogenic fungi, sowing of the material on a nutrient medium and examination of the affected areas of the skin using a Wood lamp is carried out.
Scraping is taken from the affected areas of smooth skin, and if necessary, from the nail plates. Microscopy of skin husks obtained by scraping reveals short branching filaments of mycelium and rectangular arthrospores characteristic of Epidermophyton floccosum, which form chains. Sowing the material from scraping on the Saburo nutrient medium gives the growth of yellowish colonies of rounded shape and fluffy consistency, typical of fungi that cause inguinal epidermophytosis.
Fluorescent diagnostics with a Wood lamp reveals a greenish glow of skin areas in the affected area, which confirms the fungal genesis of the disease. It allows you to distinguish between inguinal epidermophytosis and erythrasma, for which a red-coral glow is typical. Inguinal epidermophytosis is differentiated from diaper rash, candidiasis of the skin, psoriasis, allergic contact dermatitis, trichophytia of smooth skin, rubromycosis.
Patients with inguinal epidermophytosis should pay great attention to personal hygiene, especially in areas of the affected skin. It is necessary to wash daily with careful treatment of skin folds. It is useful to take baths with an infusion of chamomile, celandine, oak bark, turn. They have a drying and anti-inflammatory effect. To reduce itching and unpleasant sensations in the area of foci of inguinal epidermophytosis, oral antihistamines are prescribed: chloropyramine, clemastine, loratadine, cetirizine, etc.
With inguinal epidermophytosis, local treatment is quite effective. Apply lotions of 1% resorcinol and 0.25% silver nitrate, apply ointment with betamethasone and clotrimazole. Modern antifungal drugs widely used in dermatology give a good result: terbinafine, undecylenic acid, clotrimazole. Local antimycotic therapy is carried out for a long time (4-6 weeks), continuing it for some time after the complete disappearance of symptoms. Places of resolved foci of epidermophytosis are treated with iodine tincture or fucarcin.
Preventive measures should first of all be aimed at preventing infection of persons living together in patients. To do this, disinfection of contact surfaces, linen, bedding and household items is carried out. The patient and all his relatives should carefully follow the rules of personal hygiene.
Prevention of inguinal epidermophytosis is facilitated by individual use of personal hygiene items, compliance with hygiene rules in public showers and baths, regular body hygiene, and the fight against hyperhidrosis.