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Fungal Jock Itch vs. Inverse Psoriasis: A Common Misdiagnosis

Posted on March 17, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Sage Salvo

Uncomfortable skin conditions are challenging enough when you know exactly what they are. Sometimes a doctor may misdiagnose your symptoms, which can keep you from getting the proper treatment until a correct diagnosis is made. Such can be the case with inverse psoriasis and jock itch — a fungal infection that develops in warm, moist areas of the body. Jock itch and inverse psoriasis can cause similar symptoms, leading doctors to occasionally misdiagnose one for the other.

Getting the right diagnosis is crucial for allowing you and your health care provider to determine the best way of managing your condition.

What Is Fungal Jock Itch?

Jock itch, also known as tinea cruris, is a skin infection that most often appears in men and adolescent boys. It is caused by the spread of fungi that live on the skin, called dermatophytes, which cause a superficial fungal infection of the skin commonly called ringworm.

Dermatophytes can overgrow and cause infections in warm, moist areas, such as the buttocks, inner thighs, and groin. Intertriginous areas — areas where skin folds on itself — provide moist, warm environments in which fungus likes to grow.

The fungal infection causes symptoms including:

  • Flaking
  • Scaly patches
  • Discolored ringlike rashes, which generally appear red on lighter skin and gray or brown on darker skin

Jock itch isn’t a highly serious condition. It is temporary and can usually be resolved with over-the-counter (OTC) antifungal medication and careful hygiene.

What Is Inverse Psoriasis?

Unlike jock itch, which is a temporary infection, inverse psoriasis (also known as intertriginous psoriasis or flexural psoriasis) is a chronic inflammatory condition that can persist for a person’s entire life. Inverse psoriasis is one of the rarest forms of psoriasis, affecting just 3 percent to 7 percent of people with psoriasis.

Inverse psoriasis typically creates bright red or purple lesions that can feel inflamed and painful. Inverse psoriasis lesions form in areas of the body where skin folds and rubs together, such as the armpits, buttocks, and under the breasts — areas that are also susceptible to jock itch.

Why Is Jock Itch Misdiagnosed as Inverse Psoriasis?

Jock itch and inverse psoriasis are occasionally mistaken for each other due to their similar symptoms and appearances. Both conditions cause pain, discolored patches, and an itching sensation in and around skin folds such as the groin and buttocks.

Complicating matters is the fact that people with inverse psoriasis don’t always exhibit the symptoms most commonly associated with psoriasis as a whole. The telltale signs of plaque psoriasis — the most common form of psoriasis — are raised, dry plaques (lesions) of skin covered with silvery or gray scales. In contrast, inverse psoriasis patches are usually smooth and shiny. The moist environments they form in generally prevent them from forming characteristic scales.

If someone with a mild case of inverse psoriasis begins experiencing patches in an area often affected by jock itch, they might assume that their symptoms are caused by a fungal infection. But the best person to determine the cause of symptoms is a health care professional, like a dermatologist experienced with both fungal infections and psoriasis.

Getting a Proper Diagnosis

When making their diagnosis, doctors may visually inspect the affected area and take small skin samples (skin biopsies). They may also check for other unusual skin patches. People with inverse psoriasis often have another form of psoriasis elsewhere on their bodies, so finding a psoriasis plaque or pustular spots could help a doctor decide whether the patch is likely to be more psoriasis or more jock itch.

Can You Have Jock Itch and Inverse Psoriasis At the Same Time?

Simply put, yes. Jock itch and inverse psoriasis are different conditions with their own causes and triggers, so it’s entirely possible to develop a fungal infection in addition to psoriasis, especially if the skin is moist. “I have a fungal infection on top of inverse psoriasis, and so my day has not been good,” shared one MyPsoriasisTeam member.

Causes of Fungal Jock Itch and Inverse Psoriasis

Inverse psoriasis and jock itch may have similar symptoms and appear in the same places, but they are distinct conditions with different causes.

What Causes Jock Itch?

Jock itch is caused by an overgrowth of dermatophyte fungi in warm, moist areas of the body (known as dermatophytosis). The same variety of fungus can also cause athlete’s foot (tinea pedis). The fungi can transfer from one area of the body to another via contaminated towels or clothing. Fungus also can easily be transferred from the foot to groin area when you put on pants. Your waistband, for example, may touch your feet and other parts of your body, up to your waist, as you pull up your pants.

Jock itch infections are more likely to appear if you are male or a teenager, sweat a lot, wear tight underwear, or have a weak immune system.

What Causes Inverse Psoriasis?

Psoriasis is an autoimmune condition, meaning its symptoms occur as the result of immune attacks on the body’s own tissues. In the case of psoriasis, T cells — which normally defend against invading viruses or bacteria — begin attacking healthy skin cells. These misdirected attacks cause skin cell production to speed up dramatically, which creates the painful, reddened patches of skin, scaling, and pustules characteristic of psoriasis.

Psoriasis flare-ups typically continue throughout a person’s lifetime. However, certain environmental factors can trigger symptoms, including:

  • Infections
  • Cold weather
  • Skin injuries
  • Smoking
  • Heavy alcohol consumption
  • Certain medications

Fungal infections, like jock itch, can also trigger inverse psoriasis.

Treating Jock Itch and Inverse Psoriasis

The treatments for jock itch and inverse psoriasis are different, just like their causes. Before trying any treatment, confer with your doctor.

Treatments for Jock Itch

Typically, jock itch resolves with over-the-counter antifungal lotions, ointments, or sprays. Common OTC antifungal medications include:

  • Terbinafine, found in OTC products such as Lamisil
  • Clotrimazole, the active ingredient in Lotrimin, among other
  • Miconazole, sold in products like Micatin or Monistat

Prescription-strength topical treatments or pills are also available to treat more severe cases. If you have athlete’s foot as well as jock itch, your doctor will likely treat both to prevent the fungus from continuing to spread. The rash should improve in one week and resolve in three weeks of treatment.

Simple lifestyle changes can all help prevent future infections, including:

  • Regularly changing your undergarments
  • Showering after athletic activities
  • Maintaining good personal hygiene

Treatments for Inverse Psoriasis

Inverse psoriasis is more difficult to treat than jock itch. Because it is a chronic autoimmune disease, there is no way to eliminate symptoms permanently. However, people with inverse psoriasis can manage their symptoms and improve their quality of life with therapies such as:

Treatments for Jock Itch and Inverse Psoriasis

If you have inverse psoriasis and jock itch simultaneously, you should consult your doctor about balancing treatments for both. There are prescription creams that contain antifungal ingredients as well as topical steroids to stop inflammation.

One MyPsoriasisTeam member shared advice about managing skin symptoms, “You can get some hydrocortisone cream to stop the itch, or, if you think it’s a fungal issue, something with an antifungal in it, too,” they wrote. “My problems have been so severe that I am presently taking antibiotic and antifungal tablets from my general practitioner.”

The medications you use will depend on the severity of your case and your unique health situation. You may need to try several different medications to find a treatment approach that works for you. Your doctor is your best guide and will be able to help you manage your symptoms long-term.

Meet Your Team

Psoriasis can be a frustrating, even isolating condition — but you don’t need to navigate it alone. MyPsoriasisTeam is the social media platform designed to connect and support people who share your diagnosis. By making a free account, you can ask questions, provide advice, and share stories with more than 89,000 people who truly understand what it’s like to live with psoriasis and psoriatic arthritis.

Have you had jock itch or another fungal infection with psoriasis? Which treatments worked best? Share your story in the comments below or by starting a new conversation on MyPsoriasisTeam.

References

  1. Jock Itch — Mayo Clinic
  2. Inverse Psoriasis — National Psoriasis Foundation
  3. Jock Itch (Tinea Cruris) — Merck Manuals
  4. Psoriasis: Signs and Symptoms — American Academy of Dermatology Association
  5. Inverse Psoriasis Involving Genital Skin Folds: Successful Therapy With Dapsone — Dermatology and Therapy
  6. Plaque Psoriasis — National Psoriasis Foundation
  7. Psoriasis — Mayo Clinic
  8. Psoriasis: Causes — National Health Service
  9. Clotrimazole Topical — MedlinePlus
  10. Miconazole Topical — MedlinePlus
  11. Biologics — National Psoriasis Foundation
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sage Salvo is a content creator who specializes in developing savvy, SEO-aware content strategies and top notch ghostwritten articles for a wide variety of industry niches. Learn more about her here.

A MyPsoriasisTeam Member said:

This makes me wonder. My mother always seemed to have a yeast infection. Creams, medications, you name it she did it and nothing ever seem to make it go away. One day it would just go away only to… read more

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