Intertrigo

Intertrigo is caused by the retention of moisture, warmth, and the concomitant overgrowth of bacteria. If, the rash is not treated, bacterial or fungal infections may develop. Intertrigo is due to excessive moisture and friction, and can be infected with Candida albicans (yeast).

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 . The condition frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial, fungal, or viral. Intertrigo commonly affects the axilla, perineum, inframammary creases, and abdominal folds. It is most often due to chafing together of the warm, moist skin, especially in those who are overweight or diabetic. Infection with bacteria or yeast may then develop in the broken skin Satellite lesions, small areas of the same rash that are close to the main rash, are characteristic of intertrigo and othe r Candida skin infections. Physical exercise usually is desirable, but patients should shower afterward and dry intertriginous areas thoroughly. Also, there are several skin diseases that can cause an intertrigo to develop, such as dermatitis or inverse psoriasis .

Intertrigo develops from mechanical factors and secondary infection. Stronger topical steroid creams will be more rapidly effective, but if used for more than a few days may cause serious skin damage. 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 Physicians should educate patients about precautions with regard to heat, humidity, and outside activities. Equally important in the treatment of intertrigo is keeping the skin folds as dry as possible.

Causes of Intertrigo

The common causes of Intertrigo :

• The fungi thrive in warm, moist places on the body but attack the open areas of the body under normal conditions.
• Whether infectious agents play a primary role or simply are common secondary agents is controversial
• This condition may also be seen in people who are restricted to bed rest or in those who wear medical devices that may trap moisture against the skin, such as artificial limbs, splints, and braces.
• The fungi thrive in warm, moist places on the body but attack the open areas of the body under normal conditions.
• This condition may also be seen in people who are restricted to bed rest or in those who wear medical devices that may trap moisture against the skin, such as artificial limbs, splints, and braces.

Symtoms of Intertrigo

Some are common symtoms of Intertrigo :

• Common sites include your inner thighs, in your armpits, underneath your breasts, in the folds of the skin on your abdomen, between your fingers and toes
• Intertrigo is made worse by sweating
• The amount of skin affected increases over time (enlarging skin rash or lesion) or the rash spreads to other areas
• Skin folds such as under the breasts or in the groin may be affected ( intertrigo )
• There are some structured weight loss programs such as Weight Watchers and Jenny Craig that allow older children and adolescents to participate with parental and medical permission

Treatment of Intertrigo

The most importnt Treatment of Intertrigo :

• Skin surfaces in deep folds can be kept separated with cotton or linen cloth; however, be sure to avoid tight, occlusive, or chafing clothing or dressings.
• Greer goo is composed of nystatin (Mycostatin) powder 4 million U, hydrocortisone powder 1.2 g, and zinc oxide paste 4 oz applied qs ad (in a sufficient quantity).
• Bacteria may be treated with topical antibiotics such as fusidic acid cream, mupirocin ointment, or oral antibiotics such as flucloxacillin and erythromycin
• Yeasts and fungi may be treated with topical antifungals such as clotrimazole and terbinafine cream or oral agents such as itraconazole or terbinafine
• maintaining dryness at the affected area with cotton, and antiperspirants may be used once the area has healed
• There are some structured weight loss programs such as Weight Watchers and Jenny Craig that allow older children and adolescents to participate with parental and medical permission

Home Treatment for Intertrigo

If a rash develops, wash affected areas with water only. Soap can be irritating. Pat dry thoroughly. Apply cold, wet compresses to the rash to reduce itching. Repeat frequently. 
Leave the rash exposed to air. Baby powder can help keep it dry.

Hydrocortisone cream is useful in Intertrigo treatment. It can provide temporary relief of itching. Use sparingly on facial rashes and the genitals. 

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