Pediatric emergency medicine trisk 1845 1845

FIGURE 88.24 Nonscarring alopecia on the scalp of a child characteristic of alopecia areata.

Tinea Cruris
Tinea cruris begins as a small, red, scaling rash in the groin that spreads
peripherally and clears centrally. The edges are sharply marginated and scalloped,
extending down the thighs. Generally, the scrotum is not noticeably involved.
Other conditions to consider are seborrheic dermatitis (which usually can be
differentiated by involvement of other areas of the body such as the ears, scalp,
and eyelids), intertrigo (generally secondary to friction and maceration), contact
dermatitis, candidiasis (which usually involves the inner thigh and causes the
scrotum to appear bright red), and erythrasma (which will fluoresce under Wood
lamp). The clinician should always check the feet to ensure there is no fungal
involvement in that area as well. In general, this condition affects only
postpubertal children. Diagnosis is made by KOH preparation. Nonspecific
measures for treatment include loose-fitting clothing, reducing the amount of
perspiration. Clotrimazole, miconazole, tolnaftate, and econazole are useful as
topical antifungal agents. Rarely, oral griseofulvin may be needed in severe cases.
Tinea Pedis
Tinea pedis is generally caused by Trichophyton rubrum or Trichophyton
mentagrophytes. It occurs most commonly in postpubertal children. The cracking