Intertrigo

Last updated
Intertrigo
Axillary intertrigo.png
Axillary intertrigo (bacterial)
Pronunciation
Specialty Dermatology   OOjs UI icon edit-ltr-progressive.svg

Intertrigo refers to a type of inflammatory rash (dermatitis) of the superficial skin that occurs within a person's body folds. [1] These areas are more susceptible to irritation and subsequent infection due to factors that promote skin breakdown such as moisture, friction, and exposure to bodily secretions and excreta such as sweat, urine, or feces. [1] Areas of the body which are more likely to be affected by intertrigo include the inframammary fold, intergluteal cleft, armpits, and spaces between the fingers or toes. Skin affected by intertrigo is more prone to infection than intact skin. [1]

Contents

The term "intertrigo" commonly refers to a secondary infection with bacteria (such as Corynebacterium minutissimum ), fungi (such as Candida albicans ), or viruses. A frequent manifestation is candidal intertrigo.

Intertrigo occurs more often in warm and humid conditions. Generally, intertrigo is more common in people with a weakened immune system including children, the elderly, and immunocompromised people. [1] The condition is also more common in people who experience urinary incontinence and decreased ability to move. [1]

Cause

An intertrigo usually develops from the chafing of warm, moist skin in the areas of the inner thighs and genitalia, the armpits, under the breasts, the underside of the belly, behind the ears, and the web spaces between the toes and fingers. An intertrigo usually appears red and raw-looking, and may also itch, ooze, and be sore. Intertrigos occur more often among overweight individuals, those with diabetes, those restricted to bed rest or diaper use, and those who use medical devices, like artificial limbs, that trap moisture against the skin. Also, there are several skin diseases that can cause an intertrigo to develop, such as dermatitis or inverse psoriasis.[ citation needed ]

Bacterial

Bacterial intertrigo can be caused by Streptococci and Corynebacterium minutissimum . [1] [2]

Diagnosis

Intertrigo can be diagnosed clinically by a medical professional after taking a thorough history and performing a detailed physical examination. Many other skin conditions can mimic intertrigo's appearance including erythrasma, inverse psoriasis, scabies, pyoderma, atopic dermatitis, candidiasis, seborrheic dermatitis, and fungal infections of the superficial skin like Tinea versicolor or Tinea corporis . [1]

Treatment

Intertrigo is treated by addressing associated infections, by removing moisture from the site, and by using substances at the site to help maintain skin integrity. If the individual is overweight, losing weight may also help. Relapses of intertrigo are common.

Keeping the area of the intertrigo dry and exposed to the air can help prevent recurrences, as can removing moisture from the area using absorbent fabrics or body powders, including plain cornstarch [ citation needed ] and judiciously used antiperspirants.

Greases, oils, and barrier ointments [3] may help by protecting skin from moisture and from friction. [4] Antifungal powders, most commonly clotrimazole 1%, may also be used in conjunction with a barrier ointment. Diaper rash ointment can also help.

Fungal infections associated with intertrigo may be treated with prescription antifungals applied directly to the skin (in most cases) or systemic antifungals, including fluconazole, nystatin, and griseofulvin.

Intertrigo is also a known symptom of vitamin B6 deficiency. [5]

See also

Related Research Articles

<span class="mw-page-title-main">Tinea cruris</span> Fungal infection

Tinea cruris, also known as jock itch, is a common type of contagious, superficial fungal infection of the groin and buttocks region, which occurs predominantly but not exclusively in men and in hot-humid climates.

<span class="mw-page-title-main">Folliculitis</span> Human and animal disease of follicles

Folliculitis is the infection and inflammation of one or more hair follicles. The condition may occur anywhere on hair-covered skin. The rash may appear as pimples that come to white tips on the face, chest, back, arms, legs, buttocks, or head.

<span class="mw-page-title-main">Irritant diaper dermatitis</span> Medical condition

Irritant diaper dermatitis is a generic term applied to skin rash in the diaper area that are caused by various skin disorders and/or irritants.

<span class="mw-page-title-main">Axilla</span> Area of the human body beneath the joint between arm and torso

The axilla is the area on the human body directly under the shoulder joint. It includes the axillary space, an anatomical space within the shoulder girdle between the arm and the thoracic cage, bounded superiorly by the imaginary plane between the superior borders of the first rib, clavicle and scapula, medially by the serratus anterior muscle and thoracolumbar fascia, anteriorly by the pectoral muscles and posteriorly by the subscapularis, teres major and latissimus dorsi muscle.

<span class="mw-page-title-main">Athlete's foot</span> Skin infection caused by fungus

Athlete's foot, known medically as tinea pedis, is a common skin infection of the feet caused by a fungus. Signs and symptoms often include itching, scaling, cracking and redness. In rare cases the skin may blister. Athlete's foot fungus may infect any part of the foot, but most often grows between the toes. The next most common area is the bottom of the foot. The same fungus may also affect the nails or the hands. It is a member of the group of diseases known as tinea.

Dermatophyte is a common label for a group of fungus of Arthrodermataceae that commonly causes skin disease in animals and humans. Traditionally, these anamorphic mold genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera. Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota. As of 2019 a total of nine genera are identified and new phylogenetic taxonomy has been proposed.

<span class="mw-page-title-main">Tinea corporis</span> Medical condition

Tinea corporis is a fungal infection of the body, similar to other forms of tinea. Specifically, it is a type of dermatophytosis that appears on the arms and legs, especially on glabrous skin; however, it may occur on any superficial part of the body.

<span class="mw-page-title-main">Cradle cap</span> Human medical condition

Cradle cap causes crusty or oily scaly patches on a baby's scalp. The condition is not painful or itchy, but it can cause thick white or yellow scales that are not easy to remove. Cradle cap most commonly begins sometime in the first three months but can occur in later years. Similar symptoms in older children are more likely to be dandruff than cradle cap. The rash is often prominent around the ear, the eyebrows or the eyelids. It may appear in other locations as well, where it is called infantile seborrhoeic dermatitis. Cradle cap is just a special—and more benign—case of this condition. The exact cause of cradle cap is not known. Cradle cap is not spread from person to person (contagious). It is also not caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap often lasts a few months. In some children, the condition can last until age 2 or 3.

<span class="mw-page-title-main">Onychomycosis</span> Medical condition

Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Fingernails may be affected, but it is more common for toenails. Complications may include cellulitis of the lower leg. A number of different types of fungus can cause onychomycosis, including dermatophytes and Fusarium. Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function. The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.

<span class="mw-page-title-main">Erythrasma</span> Medical condition

Erythrasma is a superficial skin infection that causes brown, scaly skin patches. It is caused by Corynebacterium minutissimum bacteria, a normal part of skin flora.

<span class="mw-page-title-main">Hailey–Hailey disease</span> Medical condition

Hailey–Hailey disease (HHD), or familial benign chronic pemphigus or familial benign pemphigus, was originally described by the Hailey brothers in 1939. It is a genetic disorder that causes blisters to form on the skin.

<span class="mw-page-title-main">Tinea manuum</span> Medical condition

Tinea manuum is a fungal infection of the hand, mostly a type of dermatophytosis, often part of two feet-one hand syndrome. There is diffuse scaling on the palms or back of usually one hand and the palmer creases appear more prominent. When both hands are affected, the rash looks different on each hand, with palmer creases appearing whitish if the infection has been present for a long time. It can be itchy and look slightly raised. Nails may also be affected.

<span class="mw-page-title-main">Clobetasone</span> Chemical compound

Clobetasone (INN) is a corticosteroid used in dermatology, for treating such skin inflammation as seen in eczema, psoriasis and other forms of dermatitis, and ophthalmology. Topical clobetasone butyrate has shown minimal suppression of the hypothalamic–pituitary–adrenal axis.

<span class="mw-page-title-main">Clotrimazole</span> Chemical compound

Clotrimazole, sold under the brand name Lotrimin, among others, is an antifungal medication. It is used to treat vaginal yeast infections, oral thrush, diaper rash, tinea versicolor, and types of ringworm including athlete's foot and jock itch. It can be taken by mouth or applied as a cream to the skin or in the vagina.

<span class="mw-page-title-main">Tinea incognita</span> Fungal skin infection caused by the presence of a topical immunosuppressive agent

Tinea incognita, also spelled tinea incognito, is a fungal infection of the skin that generally looks odd for a typical tinea infection. The border of the skin lesion is usually blurred and it appears to have florid growth.

Topical steroids are the topical forms of corticosteroids. Topical steroids are the most commonly prescribed topical medications for the treatment of rash and eczema. Topical steroids have anti-inflammatory properties and are classified based on their skin vasoconstrictive abilities. There are numerous topical steroid products. All the preparations in each class have the same anti-inflammatory properties but essentially differ in base and price.

<span class="mw-page-title-main">Streptococcal intertrigo</span> Medical condition

Streptococcal intertrigo is a skin condition that is secondary to a streptococcal bacterial infection. It is often seen in infants and young children and can be characterized by a fiery-red color of the skin, foul odor with an absence of satellite lesions, and skin softening in the neck, armpits or folds of the groin. Newborn children and infants commonly develop intertrigo because of physical features such as deep skin folds, short neck, and flexed posture. Prompt diagnosis by a medical professional and treatment with topical and/or oral antibiotics can effectively relieve symptoms.

Two feet-one hand syndrome(TFOHS), is a long-term fungal condition where athlete's foot or fungal toe nail infections in both feet is associated with tinea manuum in one hand. Often the feet are affected for several years before symptoms of a diffuse scaling rash on the palm of one hand appear, which is when most affected people then seek medical help.

Topical antifungaldrugs are used to treat fungal infections on the skin, scalp, nails, vagina or inside the mouth. These medications come as creams, gels, lotions, ointments, powders, shampoos, tinctures and sprays. Most antifungal drugs induce fungal cell death by destroying the cell wall of the fungus. These drugs inhibit the production of ergosterol, which is a fundamental component of the fungal cell membrane and wall.

References

  1. 1 2 3 4 5 6 7 Kalra, MG; Higgins, KE; Kinney, BS (April 2014). "Intertrigo and secondary skin infections". American Family Physician. 89 (7): 569–73. PMID   24695603.
  2. Tüzün, Y; Wolf, R; Engin, B; Keçici, AS; Kutlubay, Z (July–August 2015). "Bacterial infections of the folds (intertriginous areas)". Clinics in Dermatology (Review). 33 (4): 420–8. doi:10.1016/j.clindermatol.2015.04.003. PMID   26051056.
  3. Bodkhe RB, Shrestha SB, Unertl K, Fetzik J, McNulty AK. Comparing the physical performance of liquid barrier films. Skin Res Technol. 2021 Mar 24. doi: 10.1111/srt.13038. Online ahead of print. PMID   33760305
  4. Alison Parnham, Dale Copson, Tanya Loban. Moisture-associated skin damage: causes and an overview of assessment, classification and management. Br J Nurs. 2020 Jun 25;29(12):S30-S37. doi: 10.12968/bjon.2020.29.12.S30. PMID   32579457
  5. Tong, Y (2014). "Seizures caused by pyridoxine (vitamin B6) deficiency in adults: A case report and literature review". Intractable Rare Dis Res. 3 (2): 52–6. doi:10.5582/irdr.2014.01005. PMC   4204538 . PMID   25343127.