eMedicine Specialties > Dermatology > Environmental

Intertrigo: Follow-up

Author: Samuel Selden, MD, Assistant Professor, Department of Dermatology, Eastern Virginia Medical School
Contributor Information and Disclosures

Updated: Aug 12, 2009

Follow-up

Complications

  • Since intertrigo frequently is colonized or secondarily infected, acute cellulitis is a threat.
  • Potential complications of therapy include contact dermatitis from topical agents and striae from topical steroids.

Prognosis

  • With therapy, the prognosis for each episode of simple intertrigo is excellent. Recurrence is common.

Patient Education

  • During patient instruction, emphasize topics such as weight loss, glucose control (in patients with diabetes), good hygiene, and the need for daily care and monitoring.10

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize and diagnose an infectious intertrigo may result in serious cellulitis, especially in patients who are diabetic
  • Failure to monitor patients closely for the development of striae or a hidden infection if topical steroids are needed to control an inflammatory intertrigo
  • Failure to consider biopsy if the intertrigo fails to respond to treatment or if severe skin or systemic disorders must be excluded, although skin biopsies are not necessary to diagnose uncomplicated intertrigo
  • Failure to notice skin fissuring and breakdown/ulcers possibly hidden in the deep skin folds of persons who are obese, which can lead to pain, disability, and, potentially, sepsis

Special Concerns

  • Intertrigo most often involves persons who are helpless or dependent on others, ie, older persons and infants. Since intertrigo in the perineum often is complicated by incontinence, new breakthroughs in absorbent diapers have made diaper dermatitis easier to avoid. However, contact dermatitis in reaction to these diapers, whether irritant or allergic, can occur; therefore, monitor waistlines and leg openings for intertrigo.
 


More on Intertrigo

Overview: Intertrigo
Differential Diagnoses & Workup: Intertrigo
Treatment & Medication: Intertrigo
Follow-up: Intertrigo
References
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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. Jansen GT, Dillaha CJ, Honeycutt WM. Intertrigo. In: Clinical Dermatology. Hagerstown, Md: Harper & Row; 1979.

  14. 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].

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

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Further Reading

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Keywords

intertrigo, skin inflammation, obesity, diabetes, heat rash, friction rash, diaper dermatitis, maceration rash

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Contributor Information and Disclosures

Author

Samuel Selden, MD, Assistant Professor, Department of Dermatology, Eastern Virginia Medical School
Samuel Selden, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Astellas Pharma US, Inc. Honoraria Consulting; Galderma Laboratories, L.P. Honoraria Review panel membership

Medical Editor

Franklin Flowers, MD, Chief, Division of Dermatology, Professor, Department of Medicine and Otolaryngology, 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.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University 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.

Managing Editor

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

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine 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, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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