An obese woman with poorly controlled diabetes has a red glazed rash in both inguinal folds with small pustules scattered just beyond the main margin. KOH shows budding yeasts and pseudohyphae. The feature that best distinguishes this from tinea cruris is:

• A Absence of itching
• B Involvement of the groins bilaterally
• C Well defined active scaly advancing edge
• D Presence of satellite pustules beyond the border ✓

Explanation

Cutaneous candidiasis of flexures typically shows a glazed erythematous plaque with fringing maceration and, characteristically, satellite pustules or papules just outside the main margin, reflecting localised spread by budding yeasts. Tinea cruris instead has a dry, sharply demarcated, scaly, serpiginous advancing edge without satellites. Bilateral groin involvement and itch occur in both conditions, so they do not discriminate. Management includes topical antifungals and control of moisture and glycaemia.

Reference: Fitzpatrick's Dermatology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.