Intertrigo

INTRODUCTION

Intertrigo is skin inflammation which is caused by moisture, maceration and friction, and is strictly confined to opposing skin surfaces such as in the groin and under the breasts.

GROIN RASH

Common causes of a groin rash are presented in Table I3. It is important to distinguish between tinea cruris and candidiasis and the dermograms highlight the differences. Tinea cruris is described on 456.

CANDIDA INTERTRIGO

Candida albicans superinfects a simple intertrigo and tends to affect obese or bedridden patients, esp. if incontinent.

Treatment

• Treat predisposing factors where possible (e.g. diabetes, obesity)

• Apply an imidazole preparation, such as miconazole 2% or clotrimazole 1%, bd for 14 d

• Use Burow’s solution compresses to dry a weeping area

• Keep area dry and skinfolds apart (if possible)

• Apply zinc oxide powder (e.g. Curash)

• Use short-term hydrocortisone cream for itch or inflammation (long-term aggravates the problem)

ERYTHRASMA

Erythrasma, a common and widespread chronic superficial skin infection, is caused by the bacterium Corynebacterium minutissimum. Itch is not a feature.

Clinical features

• Superficial reddish-brown scaly patches

• Enlarges peripherally

• Mild infection but tends to chronicity if untreated

• Coral pink fluorescence with Wood’s light

• Common sites: groin, axillae, submammary, toe webs

Treatment

• Erythromycin or roxithromycin (o)

• Topical imidazole