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# Jock Itch and Athlete's Foot ## Tinea Cruris (Jock Itch) - A fungal infection of the perineal area, penis, inner thighs, and inguinal creases - May also occur under breasts in young women and beneath abdominal folds where skin is warm and moist. - Rarely occurs before adolescence. - The symptom...

# Jock Itch and Athlete's Foot ## Tinea Cruris (Jock Itch) - A fungal infection of the perineal area, penis, inner thighs, and inguinal creases - May also occur under breasts in young women and beneath abdominal folds where skin is warm and moist. - Rarely occurs before adolescence. - The symptom is a scaly, itching, erythematous rash that may contain papules or vesicles and is usually bilateral and symmetrical. - **Treatment includes:** - Selenium sulfide shampoo wash of area before applying medication. - Topical antifungal (clotrimazole, miconazole, tolnaftate, naftifine, terbinafine) 2 times daily for 4 weeks. ## Tinea Pedis (Athlete's Foot) - Fungal infection of the feet and toes. - Rare before adolescence and is more common in males. - **Symptoms include:** - Severe itching with vesicles or erosion of instep and with peeling maceration and fissures between toes - Dry scaly mildly erythematous patches on plantar and lateral foot surfaces - **Treatment** is the same as tinea cruris as well as keeping feet dry with absorbant talc, allowing feet to air dry, and wearing 100% cotton socks, changed twice daily. # Parasitic Infections ## Pediculosis - Infestation with lice, transmitted by direct contact with someone who is infested. ### Head Lice (most common in children) ### Body Lice (most common in transient populations, migrants, homeless) - They feed on the body but live in clothing or bedding and are spread by sharing bedding, clothes, or towels - Pubic lice spread by sexual contact or (rare) sharing clothes or bedding and may infest the genital area, eyebrows, eyelids, lower abdomen, and beard - **Symptoms include:** - Persistent itch (usually worse at night) - Skin irritation, excoriation, and occasionally secondary infection - Visual confirmation of lice or nits - **Treatment:** Permethrin 1% (Nix) is the treatment of choice. This is a cream rinse applied after body or hair is shampooed with a non-conditioning shampoo and then towel dried. It is left on for 10 minutes and then rinsed off, leaving residue designed to kill nymphs emerging from eggs not killed with the first application. Treatment is often repeated in 7 to 10 days. Nits should be manually removed, using a special comb. ## Scabies - Caused by a microscopic mite, *Sarcoptes scabiei hominis*, which tunnels under the outer layer of skin, raising small lines (burrows) a few millimeters long. - Mites prefer warm areas, such as the webbing between the fingers and in skin folds (waist, axillae, genital areas), but can infest any area of the body. - As the mites burrow, they cause intense itching and subsequent scratching can result in excoriation and secondary infections. - Some develop a generalized red rash. - Scabies is...