Approach Considerations
The diagnosis of intertrigo usually is based on history, presentation, and physical examination. The characteristics of the lesions also provide clues to the etiology and severity.
Basic microbiologic diagnostic studies can be performed to identify a potential causative agent of intertrigo and to guide antimicrobial therapy. A skin biopsy generally is not required unless the intertrigo is refractory to medical treatment.
Laboratory Studies
Potassium hydroxide (KOH) test, Gram stain, or culture is useful to exclude primary or secondary infection and to guide intertrigo therapy.
Wood lamp examination can exclude erythrasma or pseudomonal infection.
Perform an appropriate workup if systemic disease is suspected along with the intertrigo (eg, diabetes, acrodermatitis enteropathica, necrolytic migratory erythema secondary to glucagonoma) or if intertrigo responds poorly to treatment.
Procedures
Consider biopsy if the intertrigo fails to respond to treatment or if severe skin or systemic disorders must be excluded. Skin biopsies are not necessary to diagnose uncomplicated intertrigo. Skin biopsy may help exclude psoriasis vulgaris inversa, Bowen disease, Paget disease, or metastatic carcinoma.
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Intertrigo. Courtesy of DermNet New Zealand (http://www.dermnetnz.org/assets/Uploads/fungal/candida-intertrigo/1308.jpg).
