Intertrigo - Symptoms and Treatment

Intertrigo is defined as an inflammation of the body folds, which is caused by skin rubbing against skin coupled with heat and moisture. Intertrigo is an inflammation of the top layers of skin caused by moisture, bacteria, or fungi in the folds of the skin. 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. Intertrigo is characterized by an intensely red, macerated, glistening rash with scaling on the edges. The edge of the rash extends just beyond the limits of the opposing skin folds. 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. 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

Common Causes of Intertrigo :

• Poor hygiene, may lead to intertrigo
• Intertrigo is usually yeast infection of skin folds caused by Candida albicans.
• Rare inherited conditions such as Hailey-Hailey disease may also lead to the intertrigo
• Some initiating factors such as friction, perspiration, maceration, or irritation from stool, urine, drainage, or topical agents may lead to intertrigo
• Folliculitis , caused by various bacteria especially Staphylococcus aureus, is often provoked by shaving. Painful red spots and pustules are centred on hair follicles.
• 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.
• Poor hygiene.
• Rare inherited conditions such as Hailey-hailey disease.
• Autoeczematization and infection also may be factors.

Symptoms of Intertrigo

Some common Symptoms of Intertrigo :

• Burning.
• Discharge of pus.
• Red and moist skin.
• Intertrigo is made worse by sweating.
• Armpit skin rash
• Abdominal skin rash.
• The affected area may smell cheesy or yeasty.

Treatment of Intertrigo

• The topical antibiotics such as fusidic acid cream, mupirocin ointment, or oral antibiotics such as flucloxacillin and erythromycin are very useful in reducing the bacterial infection.
• The Nizoral Cream is also ideal for killing yeast products.
• Yeasts and fungi may be treated with topical antifungals such as clotrimazole and terbinafine cream or oral agents such as itraconazole or terbinafine .
• Calcineurin inhibitors such as tacrolimus ointment or pimecrolimus cream may also prove effective for the treatment of intertrigo
• 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).
• Wash affected areas with soap and water daily.
• Sweating may be reduced with a gentle antiperspirant.

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