Intertrigo 

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

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, fungal, or viral. 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

Frequency

International

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.

Mortality/Morbidity

As a complication of more serious disease, intertrigo should be considered a comorbidity. Intertrigo becomes most serious as a source of secondary infection.

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 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

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  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].

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  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].

 
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