Intertrigo is superficial dermatitis of skin folds areas because they are the most vulnerable areas of irritation (by friction) and infection (due to moisture such as urine, faeces, sweat).

Primary Causes

• High temperature 
• Moisture 
• Friction
• Lack of air circulation

Secondary causes 

(1) Infectious

• Bacteria (such as Corynebacterium) 
• Fungus (such as Dermatophytes, Candida, Malassezia)
• Virus (such as Herpesviridae, Poxviridae, Papovaviridae, and Picornaviridae families)

(2) Non-infectious

• Flexural psoriasis
• Seborrheic dermatitis
• Atopic dermatitis
• Irritant contact dermatitis
• Hidradenitis suppurativa

Trigger factors

• Warm and humid conditions 
• Hyperhidrosis
• Obese patient
• Diabetes
• Child or elder patient 
• Immunocompromised patient
• Urine incontinence
• Immobile patient 

Intertrigo percentage caused by fungus 

• Dermatophytosis (45%)
• Tinea versicolor (12.5%)
• Candidiasis (7.5%)

Clinical features

There are three type of presentation: acute (recent onset), relapsing (recurrent), or chronic (present for more than 6 weeks). The skin areas are inflamed and reddened. It may become moist and macerated, leading to fissuring (cracks) and peeling.

Investigation

• Skin Swabs – bacterial microscopic and cultures
• Skin Scrapping – fungus microscopic and culture  
• Biopsy

Microscopic examination

Skin scrapings (by using 10% potassium hydroxide (KOH) and methylene blue staining)

Differential diagnosis

• Erythrasma
• Inverse psoriasis
• Scabies
• Atopic dermatitis
• Candidiasis
• Seborrheic dermatitis
• Superficial fungal infection (Tinea versicolor, Tinea corporis)

Treatment 

Keep the affected area clean, dry and exposed. Use Body powder containing corn starch or antifungal powder containing 1% clotrimazole. You may use less potent topical steroid such as hyrdrocortisone, antibiotics (Clindamycin, Erythromycin, fusidic acid, mupirocin) and topical antifungal (miconazole, terbinafine, clotrimazole, ketoconazole). Oral antibiotic such as erythromycin, flucloxacillin, cephalexin and/or antifungal agents (Fluconazole, Griseofulvin, Nystatin) can be used according to the recommendation of doctor. Sometimes, oral vitamin B6 should be given as a supplement in intertrigo patient.

Dr. Aye Min Htoo

(Dermatologist)

If you have been suffering from some of the above symptoms, you should contact a local dermatologist or by calling 092051590 for further advanced treatment.

အကယ်၍ အထက်ဖော်ပြပါ လက္ခဏာအချို့ကို ခံစားနေရပါက နီးစပ်ရာ အရေပြားအထူးကုဆရာဝန်ထံသို့ဖြစ်စေ (သို့မဟုတ်) အဆင့်မြင့် ရောဂါကုသမှုအတွက် 092051590 သို့ဖြစ်စေ ဆက်သွယ်နိုင်သည်။