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