Intertrigo
General Information
Intertrigo refers to an inflammation of the body folds, which is usually located in the inner thighs, armpits, and underside of the breasts or belly. It is red and raw looking and may itch, ooze or be a little sore. Intertrigo is common, especially in hot humid climates. The condition is a frequent complication of diabetes or in those who are overweight; it also affects most infants as a component of diaper dermatitis. Keeping the folds cool and dry and eliminating any friction to the area is vital to improving this condition, absorbent powders, compresses with Burow’s solution 1:40 dilute vinegar or wet tea bags often are and effective treatment, especially if followed by fanning or cool blow-drying. Where appropriate, antimycotic agents (miconazole, clotrimazole) can help, especially if used with a mild (class IV-VI) steroid for a short duration. Castellani paint (carbol-fuchsin paint) also can be beneficial. Formulations combining protective agents, antimicrobials, and topical steroids may be of use including the following: Triple Paste comprises petrolatum, zinc oxide paste, and aluminum acetate (Burow) solution applied. A thick coat of these protective barrier creams should be applied. Commercially available barrier pastes sold for diaper dermatitis (e.g., Desitin) can help, as can absorbent diapers.
Epidemiology
Common, especially in hot humid environments
Etiology
Friction, perspiration, maceration, or irritation from stool, urine, drainage, or topical agents. Autoeczematization and infection also may be factors
Pathogenesis
Insidious onset of itching, burning, and stinging in skin folds
Clinical
Erythema and weeping may progress to maceration and crusting. Fissuring may follow erosion. Pustules or vesicles may herald infection. In the perineum, depths of the skin folds are involved compared to purely irritant diaper dermatitis in which only convex surfaces are involved.
Histology
Shows no characteristic features.
Bibliography
1. “Intertrigo” (Online). March 2007. http://www.emedicine.com/derm/topic198.htm (visited: March 20, 2008) 2. “Intertrigo” (Online). http://www.aocd.org/skin/dermatologic_diseases/intertrigo.html (visited: March 20, 2008)
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Intertrigo