Medication Summary
The goals of pharmacotherapy for intertrigo are to reduce morbidity and to prevent complications.
Protective agents
Class Summary
Used to protect skin against contact irritants.
Petrolatum, zinc oxide, and aluminum acetate (Triple Paste)
Consists of petrolatum, zinc oxide paste, and aluminum acetate solution.
Mycostatin, hydrocortisone, zinc oxide (Greer goo)
Consists of nystatin (Mycostatin) powder, 4 million U, hydrocortisone powder, 1.2 g, and zinc oxide paste, 4 oz qs ad (in a sufficient quantity).
Zinc oxide (Desitin)
For relief of rash, superficial wounds, and burns.
Dimethicone (Tetrix)
Hydrophobic barrier cream.
Antifungal agents
Class Summary
Exert fungicidal effect by altering permeability of fungal cell membrane. Mechanism of action may also involve an alteration of RNA and DNA metabolism or an intracellular accumulation of peroxide toxic to fungal cells.[8]
Carbol-Fuchsin (Castellani Paint)
First aid antiseptic and drying agent. Active ingredient is phenol 1.5%. Inactive ingredients are water, SD alcohol 40B (13%), resorcinol, acetone, and basic fuchsin.
Miconazole (Micatin, Monistat-Derm, Monistat) cream
Damages fungal cell wall membrane by inhibiting biosynthesis of ergosterol. Membrane permeability is increased, causing nutrients to leak out, resulting in fungal cell death.
Lotion is preferred in intertriginous areas. If cream is used, apply sparingly to avoid maceration effects.
Clotrimazole (Lotrimin, Mycelex, Gyne-Lotrimin)
Broad-spectrum antifungal agent that inhibits yeast growth by altering cell membrane permeability, causing death of fungal cells.
Immunosuppressant agents
Class Summary
These agents exert anti-inflammatory effect by inhibiting T-lymphocyte activation. Safer than topical steroids for prolonged use or in skin folds.[9]
Tacrolimus ointment (Protopic)
Nonsteroidal anti-inflammatory agent. Should not cause steroid-type skin atrophy.
Currently indicated only for atopic dermatitis in nonimmunocompromised patients ≥ 2 y.
Pimecrolimus (Elidel cream 1%)
Nonsteroidal anti-inflammatory agent. Should not cause steroid-type skin atrophy. Currently indicated only for atopic dermatitis in nonimmunocompromised patients ≥ 2 y. Use cream sparingly to avoid maceration in skin folds.
Weston WL, Lane AT, Weston JA. Diaper dermatitis: current concepts. Pediatrics. Oct 1980;66(4):532-6. [Medline].
English JC III, Derdeyn AS, Wilson WM, Patterson JW. Axillary granuloma parakeratosis. J Cutan Med Surg. 2003;7(4):330-332.
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].
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].
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].
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].
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].
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].
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].
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].
Arnold HL, Odom RB, James WD. Intertrigo. In: Andrew's Diseases of the Skin: Clinical Dermatology. 8th ed. Philadelphia, Pa: WB Saunders; 1990:285.
Clark RA, Hopkins TT. Dermatology. 3rd ed. Philadelphia, Pa: WB Saunders; 1992:485-89.
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].
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].
Jansen GT, Dillaha CJ, Honeycutt WM. Intertrigo. In: Clinical Dermatology. Hagerstown, Md: Harper & Row; 1979.
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].
Syed ZU, Khachemoune A. Inverse psoriasis: case presentation and review. Am J Clin Dermatol. Apr 1 2011;12(2):143-6. [Medline].
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].
White GM. Regional Dermatology. Chicago, Ill: Mosby-Wolfe; 1994.
Wolf R, Barzilai A, Davidovici B. Intertriginous lymphomatoid drug eruption. Int J. Dermatol. OCT 2010;49(10):1207-9. [Medline].
Print
