CASE REPORT

IDENTIFICATION
Name : Mr. B
Sex : Male
Age : 17 years old
Education : Senior High School
Occupation : Student
Religion : Islam
Marital Status : Single
Address : Cibinong
MR Number : 377109

ANAMNESIS
Autoanamnesis was conducted on 19 Feb 2018 at 09.30 AM in Dermatology Clinic of Moh
Ridwan Meuraksa Hospital

CHIEF COMPLAINT
Itching and black patches located on groin, worsening when sweating since 1 month ago.

HISTORY OF PRESENT ILLNESS

Patient submitted to Dermatology Clinic of Moh Ridwan Meuraksa Hospital
complaining of itchy, black patches on groin since 1 month ago. Quality of the itch is
described by the patient as constant, but became unbearable when sweating that the patient
often scratch it. The black patches were initially small, then spread to surrounding area. The
patient do not have allergy to specific food and medication. Insect bite or any contact with
chemical substance denied. And the patient is not in medication
Black patches on other region denied, no black patch with hard scale, fever denied,
itching and burning skin sensation denied.
Patient take a bath and change his underwear twice a day, never share his clothes or
towel with other people. The patient like to do sport, but rarely change his clothes after
sweating.
Patient live with his family, no family member have similar symptom. The floor is
made of ceramic tiles, the house have good ventilation and good lighting.

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PAST MEDICAL HISTORY
Patient denied any previous history or previous treatments for this condition.
Patient denied a history of allergy diabetes mellitus, hypertension, rhinistis and asthma.

FAMILY MEDICAL HISTORY

Patient denied history of the same disease in the family.
Denied a history of diabetes mellitus, hypertension, rhinitis and asthma.

PHYSICAL EXAMINATION
On physical examination the patient seem cooperative, compos mentis, well
developed and well nourished with stable blood pressure, pulse, respiratory rate and afebrile.

HEENT : Head is normocephalic

EYES : Normal Conjunctivae. Sclerae are anicteric.
NECK : There is thyroid swelling and no adenopathy.
THORAX : Hearth : Regular first and second heart sound, no murmurs and gallops
Lung : Vesicular breath sounds, no ronchi and wheezing
ABDOMEN : No abdominal tenderness, normal bowel sound.
GENITAL : The physical examination on genitalia was not conducted
MUSCULOSKELETAL: Normal, no edema

Dermatological status on the region of left and right inguinal

looks hyperpigmentation plaques, circumscribed, polycyclic and squama.

SUPPORTING EXAMINATION :
The supporting examinations were not conducted

RESUME
A man aged 17 years old, came to dermatology clinic of Moh Ridwan Meuraksa
hospital, with complaints itchy black patches on the groin since 1 month ago. When sweating,
the itch became worse. Originally appeared in the form of black spots on the groin area,
getting larger became black patches. Patient take a bath and change his underwear twice a

2
day, never share his clothes or towel with other people. The patient rarely change his clothes
after sweating.
The physical examinations were normal. Dermatological status on the region of left
and right inguinal looks hyperpigmentation plaques, circumscribed, polycyclic and squama.

FINAL DIAGNOSIS

- Tinea Cruris

DIFFERENTIAL DIAGNOSIS

- Erythrasma
- Candidiasis
- Psoriasis
- Contact dermatitis

TREATMENT
Non-medicamentose
 Explain to patient that the disease is caused by fungi
 Explain to patient to use the medication given and do not stop using it without doctor’s
consent
 Have good personal hygiene, take a bath twice a day using soap. And change into dry
clothes after sweating
 Dry off with a clean towel immediately after showering, swimming or perspiring.
 Shower after physical activities.
 Do not share clothes and towel with other people.
 Avoid scratching the itch as much as possible. Scratching causes skin to become irritated
and infected.

Medicamentose

- Systemic medication :
1. Oral antimycotic: Ketoconazole 200mg once a day after breakfast in the morning for
2 weeks
2. Oral Antihistamine : Loratadin 10mg once a day for 10 days

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 - Topical medication :
1. Ketoconazole 2% twice a day for 2-4 weeks

PROGNOSIS
Quo ad vitam : ad bonam
Quo ad functionam : ad bonam
Quo ad sanationam : dubia ad bonam