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intertrigo

Inflammation/infection of intertriginous spaces. Etiology: 1) friction 2) sweat retention 3) moisture 4) warmth 5) concomittant overgrowth of resident microorganisms - commonly due to candidiasis or Staphylococcus [2] - Trichophyton rubrum + T interdigitale, Tinea cruris Epidemiology: 1) young children 2) obese adults Pathology: - Candida intertrigo is a superficial infection & does not cause systemic toxicity [] Clinical manifestations: 1) body folds (moist areas) a) initial pustules on an erythematous base become eroded & confluent b) progression to well-defined erythematous eroded patches with small pustular lesions at periphery is suggestive of candidiasis [2]; Candida satellite lesions [3] c) does not spare scrotum [2] 2) interdigital (erosio interdigitalis blatomycetica) a) initial pustule becomes eroded with formation of superficial erosion or fissure b) may be surrounded by thickened white skin * images [4,5] Differential diagnosis: - erythrasma - Tinea cruris generally spares scrotum Management: 1) keep area clean, dry 2) benzoyl peroxide topical 2.5% diminishes overgrowth of resident microorganisms 3) absorbase PRN 4) topical glucocorticoid, hydrocortisone 1% PRN - topical antifungal agent can be added to topical glucocorticoid if candidiasis suspected.

Related

candidiasis intertriginous

General

skin disease (dermatologic disorder, dermatopathy, dermatosis) sign/symptom

References

  1. Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 718, 718-720
  2. Medical Knowledge Self Assessment Program (MKSAP) 15, 17. American College of Physicians, Philadelphia 2009. 2015 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
  4. DermNet NZ (images) Intertrigo http://dermnetnz.org/dermatitis/intertrigo.html
  5. Dermnet. Skin Disease Atlas (images) http://www.dermnet.com/images/Intertrigo
  6. Selden ST, James WD Medscape: Intertrigo http://emedicine.medscape.com/article/1087691-overview
  7. NEJM Knowledge+ Endocrinology