Intertrigo

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. Moisture has a tendency to collect between the skin folds. Friction between the two moist opposing skin surfaces causes maceration of the skin. The macerated skin is then easily infected with bacteria and yeast.

Intertrigo is a red, moist irritation or infection of the crease areas of the body, especially the genitocrural (groin) area of more obese individuals. It is due to excessive moisture and friction, and can be infected with Candida albicans (yeast). It may more rarely be caused by Group A Streptococcus as well. If your child has a persistent "yeast infection" in an armpit or groin crease that does not clear with steroid creams and emollients or perhaps antifungal treatment, it might be such a streptococcal infection. Intertrigo tends to occur in warm, moist areas of the body where two skin surfaces rub or press against each other. It is most common in obese individuals. This condition may also be seen in people who are restricted to bed rest or in those who wear medical devices that may trap moisture against the skin, such as artificial limbs, splints, and braces.

Symptoms of intertrigo can appear wherever the skin falls in folds: usually around the armpits, the belly, the inner thighs, or under the breasts. Chafing causes the skin to become red. Continued chafing creates raw spots, where the skin is broken open. These areas may itch, burn, or sting. Bacteria or yeast can enter through cracks in the skin, causing infection.

The most important treatment for intertrigo is to keep the area clean and dry. Your doctor may prescribe a cream to treat soreness and itching. If you have developed a bacterial or yeast infection, your doctor will order topical or oral medications to treat the infection. You may want to use small pads of absorbent cloth to wick moisture away from skin folds or dust the area with a moisture-absorbing powder. If the patient does not take steps to reduce skin folds, such as losing weight, this condition is likely to follow a cycle of healing and recurring. Bacteria may be treated with topical antibiotics such as fusidic acid cream, mupirocin ointment, or oral antibiotics such as flucloxacillin and erythromycin. Yeasts and fungi may be treated with topical antifungals such as clotrimazole and terbinafine cream or oral agents such as itraconazole or terbinafine. Inflammatory skin diseases are often treated with low potency topical steroid creams such as hydrocortisone. More potent steroids are usually avoided in the flexures because they may cause skin thinning resulting in stretch marks (striae) and even ulcers.