Intertrigo Clinical Presentation

  • Author: Samuel T Selden, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Mar 27, 2012
 

History

  • Intertrigo usually is chronic with insidious onset of itching, burning, and stinging in skin folds.
  • When acute discomfort is noted, consider secondary infection.
  • Intertrigo commonly is seasonal, associated with heat and humidity or strenuous activity in which chafing occurs.
  • In addition to obesity and diabetes, hyperhidrosis may be a risk factor for intertrigo.
  • Additional factors that predispose individuals to perineal intertrigo include urinary or fecal incontinence, vaginal discharge, or a draining wound.
Next

Physical

  • The appearance of intertrigo is dependent on the skin area involved and the duration of inflammation. 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.
  • Any skin fold may be involved with intertrigo. In adults or infants who are obese, skin folds are accentuated, and inflammation may occur under pendulous abdominal folds, in neck creases, or in popliteal or antecubital fossae.
  • As the mandible shrinks in elderly persons and the vertical dimensions decrease around the mouth, inflammation and candidiasis can occur under the accentuated nasolabial fold that develops.
Previous
Next

Causes

  • Initiating factors include friction, perspiration, maceration, or irritation from stool, urine, drainage, or topical agents.
  • Autoeczematization and infection also may be factors in intertrigo.
  • Whether infectious agents play a primary role in intertrigo or simply are common secondary agents is controversial.[4]
Previous
Proceed to Differential Diagnoses
 
 
Contributor Information and Disclosures
Author

Samuel T Selden, MD  Assistant Professor Department of Dermatology Eastern Virginia Medical School; Consulting Staff, Chesapeake General Hospital; Private Practice

Samuel T Selden, MD is a member of the following medical societies: American Academy of Dermatology and International Society of Geriatric Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Franklin Flowers, MD  Chief, Division of Dermatology, Professor, Department of Medicine and Otolaryngology, Affiliate Associate Professor of Pediatrics and Pathology, University of Florida College of Medicine

Franklin Flowers, MD, is a member of the following medical societies: American College of Mohs Micrographic Surgery and Cutaneous Oncology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Paul Krusinski, MD  Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Weston WL, Lane AT, Weston JA. Diaper dermatitis: current concepts. Pediatrics. Oct 1980;66(4):532-6. [Medline].

  2. English JC III, Derdeyn AS, Wilson WM, Patterson JW. Axillary granuloma parakeratosis. J Cutan Med Surg. 2003;7(4):330-332.

  3. Hahler B. An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Manage. Jun 2006;52(6):34-6, 38, 40 passim. [Medline].

  4. Mistiaen P, Poot E, Hickox S, Jochems C, Wagner C. Preventing and treating intertrigo in the large skin folds of adults: a literature overview. Dermatol Nurs. Feb 2004;16(1):43-6, 49-57. [Medline].

  5. Honig PJ, Frieden IJ, Kim HJ, Yan AC. Streptococcal intertrigo: an underrecognized condition in children. Pediatrics. Dec 2003;112(6 Pt 1):1427-9. [Medline].

  6. Mommers JM, Seyger MM, van der Vleuten CJ, van de Kerkhof PC. Interdigital psoriasis (psoriasis alba): renewed attention for a neglected disorder. J Am Acad Dermatol. Aug 2004;51(2):317-8. [Medline].

  7. Bjornsdottir S, Gottfredsson M, Thorisdottir AS, et al. Risk factors for acute cellulitis of the lower limb: a prospective case-control study. Clin Infect Dis. Nov 15 2005;41(10):1416-22. [Medline].

  8. Dogan B, Karabudak O. Treatment of candidal intertrigo with a topical combination of isoconazole nitrate and diflucortolone valerate. Mycoses. Sep 2008;51 Suppl 4:42-3. [Medline].

  9. Martin Ezquerra G, Sanchez Regana M, Herrera Acosta E, Umbert Millet P. Topical tacrolimus for the treatment of psoriasis on the face, genitalia, intertriginous areas and corporal plaques. J Drugs Dermatol. Apr 2006;5(4):334-6. [Medline].

  10. American Academy of Family Physicians. Information from your family doctor. Intertrigo: what you should know. Am Fam Physician. Sep 1 2005;72(5):840. [Medline].

  11. Arnold HL, Odom RB, James WD. Intertrigo. In: Andrew's Diseases of the Skin: Clinical Dermatology. 8th ed. Philadelphia, Pa: WB Saunders; 1990:285.

  12. Clark RA, Hopkins TT. Dermatology. 3rd ed. Philadelphia, Pa: WB Saunders; 1992:485-89.

  13. Del Rosso JQ. Adult seborrheic dermatitis: a status report on practical topical management. J Clin Aesthet Dermatol. May 2011;4(5):32-8. [Medline]. [Full Text].

  14. Hoeger PH, Start S, Jost G. Efficacy and safety of two different antifungal pastes in infants with diaper dermatitis: a randomized, controlled study. J Eur Acad Dermatol Venereol. Sept 2010;24(9):1094-8. [Medline].

  15. Jansen GT, Dillaha CJ, Honeycutt WM. Intertrigo. In: Clinical Dermatology. Hagerstown, Md: Harper & Row; 1979.

  16. Kaya TI, Delialioglu N, Yazici AC, Tursen U, Ikizoglu G. Medical pearl: Blue underpants sign--a diagnostic clue for Pseudomonas aeruginosa intertrigo of the groin. J Am Acad Dermatol. Nov 2005;53(5):869-71. [Medline].

  17. Syed ZU, Khachemoune A. Inverse psoriasis: case presentation and review. Am J Clin Dermatol. Apr 1 2011;12(2):143-6. [Medline].

  18. Vanhooteghem O, Szepetiuk G, Paurobally D, Heureux F. Chronic interdigital dermatophytic infection: a common lesion associated witih potentially severe consequences. Diabetes Res Clin Pract. Jan. 2011;91(1):23-5. [Medline].

  19. White GM. Regional Dermatology. Chicago, Ill: Mosby-Wolfe; 1994.

  20. Wolf R, Barzilai A, Davidovici B. Intertriginous lymphomatoid drug eruption. Int J. Dermatol. OCT 2010;49(10):1207-9. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.