Clindamycin skin rash12/26/2023 The characteristics of intertriginous lesions (e.g., erosions, vesicles, pustules, nodules, papules, plaques, macules) can indicate the type of disorder present. Whether Malassezia-complicated intertrigo is a distinct entity or a type of seborrheic dermatitis remains unclear.ĭiagnosis of intertrigo and its secondary complications often is clear and is generally based on clinical manifestations. 9 Sometimes seborrheic dermatitis is located in the folds. Yeasts also are commonly found at the site of interdigital intertrigo. Dermatophytes and bacterial infections often occur together in interdigital areas. aureus and GABHS and occasionally are caused by Staphylococcus saprophyticus or other coagulase-negative staphylococci. Gram-positive infections usually are caused by S. 7, 8 However, gram-negative and gram-positive infections occasionally occur simultaneously in interdigital areas. aeruginosa combined with other gram-negative bacteria such as Moraxella, Alcaligenes, Acinetobacter, and Erwinia. Gram-negative toe web infections often are caused by P. Gram-positive and gram-negative bacteria also can worsen the effects of interdigital intertrigo. 5ĭermatophytes (e.g., Trichophytonrubrum, Trichophyton mentagrophytes, Epidermophyton floccosum) commonly complicate interdigital intertrigo. Persons with prominent skinfolds on either side of the chin are at a high risk for intertrigo. 3, 4 Drooling also can facilitate intertrigo in infants. Infants are at high risk for intertrigo because they have short necks, relative chubbiness, and flexed posture. Toe interweb intertrigo may be associated with closed-toe or tight-fitting shoes and commonly affects persons participating in athletic, occupational, or recreational activities. Other predisposing risk factors include urinary and fecal incontinence, hyperhidrosis, poor hygiene, and malnutrition. The condition is particularly common in obese patients with diabetes who are exposed to high heat and humidity, but it can occur in anyone. 3 Intertrigo is facilitated by moisture trapped in deep skinfolds where air circulation is limited. Intertrigo is primarily caused by skin-on-skin friction and is characterized by initial mild erythema that may progress to a more intense inflammation with erosions, oozing, exudation, maceration, and crusting. Secondary bacterial and fungal infections should be treated with antiseptics, antibiotics, or antifungals, depending on the pathogens. Wearing open-toed shoes can be beneficial for toe web intertrigo. Physical exercise usually is desirable, but patients should shower afterward and dry intertriginous areas thoroughly. Physicians should educate patients about precautions with regard to heat, humidity, and outside activities. Patients should wear light, nonconstricting, and absorbent clothing and avoid wool and synthetic fibers. The usual approach to managing intertrigo is to minimize moisture and friction with absorptive powders such as cornstarch or with barrier creams. The friction in these folds can lead to a variety of complications such as secondary bacterial or fungal infections. The condition appears in natural and obesity-created body folds. Intertrigo may present as diaper rash in children. It is a common skin condition affecting opposing cutaneous or muco-cutaneous surfaces. Intertrigo is inflammation of skinfolds caused by skin-on-skin friction.
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