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Intertrigo

  • Author: Samuel T Selden, MD; Chief Editor: William D James, MD  more...
 
Updated: Feb 26, 2016
 

Background

Intertrigo (intertriginous dermatitis) is an inflammatory condition of skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Intertrigo frequently is worsened or colonized by infection, which most commonly is candidal but also may be bacterial or viral or due to other fungal infection. Intertrigo commonly affects the axilla, perineum, inframammary creases, and abdominal folds.[1, 2] Diaper dermatitis shows significant overlap with intertrigo. Intertrigo is a common complication of obesity and diabetes.[3]

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Pathophysiology

Intertrigo develops from mechanical factors and secondary infection. Heat and maceration are central to the process. Opposing skin surfaces rub against each other, causing erosions that become inflamed. Sweat, feces, urine, and vaginal discharge may aggravate intertrigo in both adults and infants.

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Epidemiology

International frequency

Intertrigo is common, especially in hot humid environments. Intertrigo is a common complication of diabetes, and it affects most infants as a component of diaper dermatitis.

Race

Intertrigo has no racial predilection.

Sex

Intertrigo has no sex predilection, other than that from anatomic differences.

Age

Intertrigo affects people who are very old and very young because of reduced immunity, immobilization, and incontinence.

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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, International Society of Geriatric Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

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, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

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, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Franklin Flowers, MD Department of Dermatology, Professor Emeritus Affiliate Associate Professor of Pathology, University of Florida College of Medicine

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

Disclosure: Nothing to disclose.

References
  1. Weston WL, Lane AT, Weston JA. Diaper dermatitis: current concepts. Pediatrics. 1980 Oct. 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. 2006 Jun. 52(6):34-6, 38, 40 passim. [Medline].

  4. Kalkan G, Duygu F, Bas Y. Greenish-blue staining of underclothing due to Pseudomonas aeruginosa infection of intertriginous dermatitis. J Pak Med Assoc. 2013 Sep. 63(9):1192-4. [Medline].

  5. 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. 2005 Nov. 53(5):869-71. [Medline].

  6. 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. 2004 Feb. 16(1):43-6, 49-57. [Medline].

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

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

  9. 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. 2004 Aug. 51(2):317-8. [Medline].

  10. 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. 2005 Nov 15. 41(10):1416-22. [Medline].

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

  12. Hoeger PH, Stark 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. 2010 Sep. 24(9):1094-8. [Medline].

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

  14. 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. 2006 Apr. 5(4):334-6. [Medline].

  15. 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].

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

  17. James WD, Berger T, Elston DM. Andrew's Diseases of the Skin: Clinical Dermatology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2015.

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