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tinea cruris erythematous scaly plaque with crust in skin fold

This looks like a localized inflammatory skin lesion in a skin fold. I can't diagnose it from one photo, and the most likely cause is a fungal infection.
What I see
  • It's a small, well-defined patch at the crease of the skin, probably the armpit or groin, in a hairy area.
  • The centre is red to dusky pink, with crust and flaking.
  • Yellow-orange staining surrounds it. That may be from a topical antiseptic or home remedy such as povidone-iodine or turmeric, or it may be crusting.
  • The skin around it looks otherwise normal, with no obvious pus, swelling or spreading redness.
Most likely: tinea (a dermatophyte or "ringworm" fungal infection), e.g. tinea cruris if this is the groin
  • Textbooks describe tinea cruris as an erythematous, scaling lesion in an intertriginous area, usually itchy. The usual organisms are T. rubrum, T. mentagrophytes and E. floccosum (Jawetz, Melnick & Adelberg's Medical Microbiology 28E).
  • It typically starts as a small red, scaly or crusted patch. It spreads outward and partly clears in the centre, leaving a curved, well-defined, active border (Andrews' Diseases of the Skin, Tinea Cruris).
  • In men it spares the scrotum (Harrison's Principles of Internal Medicine 22E, Dermatophytosis).
  • Your lesion is small and crusted rather than ring-shaped, so this is not a classic picture. Topical treatment or rubbing may have changed how it looks.
Other possibilities
  • Intertrigo or friction dermatitis, from sweat and rubbing
  • Candidal intertrigo, which usually looks beefy red with small satellite spots
  • Erythrasma, a bacterial infection that is more brown and flat
  • Impetigo or a secondary bacterial infection, which tends to have honey-coloured crust
  • Inverse psoriasis, which usually shows sharply demarcated, smooth red plaques (Fitzpatrick's Dermatology)
  • Contact dermatitis, for example from a topical product or irritant
  • Less likely, a single non-healing lesion that needs a biopsy
What to do
  • Keep the area clean and dry, and avoid tight clothing and friction.
  • Don't apply steroid creams unless a doctor advises it. They can make fungal infections worse and change how they look.
  • See a doctor or dermatologist if it's spreading, painful, oozing or getting worse. Also go if you have fever or swollen glands, or if it hasn't improved after 1 to 2 weeks of an over-the-counter antifungal (clotrimazole or terbinafine cream).
  • A skin scraping with a KOH test confirms a fungal infection quickly. Diabetes or low immunity makes a prompt visit more important.
Please tell me:
  • Where the lesion is on the body
  • How long you've had it
  • Whether it itches or hurts
  • Whether you've used any creams
With that I can narrow it down.

Can i use candid R ointment

Searching the Web

Candid-R ointment composition clotrimazole Glenmark

Searching the Web

"Candid R" ointment India ingredients

I couldn't confirm what "Candid-R ointment" contains. Searches only returned Candid-B (clotrimazole + beclomethasone, a steroid), and nothing for "Candid-R." I don't want to guess, so check the ingredients on the box before you use it.
If the label says clotrimazole alone
  • It's a reasonable thing to try, because clotrimazole is an antifungal and a fungal infection is the most likely cause here.
  • Apply a thin layer to the lesion and about 2 cm of skin around it, twice daily.
  • Continue for 2 weeks after it looks clear. Stopping early often lets it come back.
  • Keep the area dry, and wear loose cotton clothing.
  • Ointments are greasy and trap moisture in a skin fold. A cream, powder or spray often suits folds better.
If the label lists a steroid (beclomethasone, betamethasone, clobetasol, mometasone and so on)
  • Don't use it for now.
  • Steroid combinations can calm the redness and itch while the fungus keeps spreading. This is called tinea incognito, and it makes the rash harder to diagnose later.
  • Skin folds absorb steroids more readily, which raises the risk of thinning and stretch marks.
  • Prescription-only steroid combinations are best used after a doctor has confirmed the diagnosis.
If the label lists an antibiotic (for example mupirocin or fusidic acid)
  • That would suit a bacterial infection like impetigo better than a fungal one. It wouldn't treat fungus.
Stop and see a doctor if:
  • It burns, stings or gets redder after you apply it.
  • It hasn't clearly improved after 1 to 2 weeks.
  • It spreads, oozes pus or becomes painful.
  • You have fever, diabetes or low immunity.
If you tell me the ingredients printed on the tube, I can say whether it's appropriate.
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